Published online Jun 10, 2015. doi: 10.4253/wjge.v7.i6.617
Peer-review started: June 16, 2014
First decision: July 29, 2014
Revised: February 10, 2015
Accepted: March 5, 2015
Article in press: March 9, 2015
Published online: June 10, 2015
Processing time: 384 Days and 18.3 Hours
The endoscopic approach for biliary diseases in patients with surgically altered gastrointestinal anatomy (SAGA) had been generally deemed impractical. However, it was radically made feasible by the introduction of double balloon endoscopy (DBE) that was originally developed for diagnosis and treatments for small-bowel diseases. Followed by the subsequent development of single-balloon endoscopy (SBE) and spiral endoscopy (SE), interventions using several endoscopes for biliary disease in patients with SAGA widely gained an acceptance as a new modality. Many studies have been made on this new technique. Yet, some problems are to be solved. For instance, the mutual unavailability among devices due to different working lengths and channels, and unestablished standardization of procedural techniques can be raised. Additionally, in an attempt to standardize endoscopic procedures, it is important to evaluate biliary cannulating methods by case with existence of papilla or not. A full comprehension of the features of respective scope types is also required. However there are not many papers written as a review. In our manuscript, we would like to evaluate and make a review of the present status of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography applying DBE, SBE and SE for biliary diseases in patients with SAGA for establishment of these modalities as a new technology and further improvement of the scopes and devices.
Core tip: This study is a review of the status of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography using several endoscopic methods in patients with surgically altered gastrointestinal anatomy, evaluating the results from multiple centers over the world. The descriptions of features of the respective endoscopes including the introduction of new endoscopes are summarized. Assessment of the procedures is concretely made by type of reconstruction methods and by type of applied endoscopes, which suggests the present and future challenges to be overcome.