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Endoscopy 2004; 36(11): 972-975
DOI: 10.1055/s-2004-825867
Original Article
© Georg Thieme Verlag Stuttgart · New York

Pancreatic Endosonography after Billroth II Gastrectomy

J.  H.  Lee1 , M.  Topazian2
  • 1Section of Digestive Diseases, Dept. of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
  • 2Division of Gastroenterology and Hepatology, Dept. of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
Further Information

Publication History

Submitted 22 July 2003

Accepted after Revision 21 May 2004

Publication Date:
02 November 2004 (online)

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Background and Study Aims: Prior Billroth II gastrectomy is considered a relative contraindication to endoscopic ultrasonography (EUS) of the pancreatic head. This study reviews experience with pancreatic EUS in such patients.
Patients and Methods: Eleven patients were identified who had previous Billroth II gastrectomy and underwent attempted pancreatic EUS.
Results: Examination of the pancreatic head was technically feasible in 10 of the patients. The inferior pancreatic head, ampulla, and periampullary ducts were seen in all; the superior pancreatic head and porta hepatis were visualized in 50 % of cases with radial echo endoscopes and 100 % with a linear-array echo endoscope. The pancreatic neck was fully imaged in 25 % of cases with radial echo endoscopes and in 60 % with a linear-array echo endoscope. One known pancreatic neck mass was not visualized.
Conclusions: Pancreatic EUS is technically feasible in most patients with a prior Billroth II gastrectomy. Linear-array echo endoscopes provide a more complete examination than radial echo endoscopes. The pancreatic neck may be difficult to visualize.

References

  • 1 Mallery S, Van Dam J. Current status of diagnostic and therapeutic endoscopic ultrasonography.  Radiol Clin North Am. 2001;  39 449-463
    CrossrefPubMedGoogle Scholar
  • 2 Feitoza A B, Baron T H. Endoscopy and ERCP in the setting of previous upper GI tract surgery, 1: reconstruction without alteration of pancreaticobiliary anatomy.  Gastrointest Endosc. 2001;  54 743-749
    CrossrefPubMedGoogle Scholar
  • 3 Deprez P. Approach of suspected common bile duct stones: endoscopic ultrasonography.  Acta Gastroenterol Belg. 2000;  63 295-298
    PubMedGoogle Scholar

M. Topazian, M. D.

Division of Gastroenterology and Hepatology, Mayo Clinic

200 First Street S. W. · Rochester, MN 55905 · USA

Fax: +1-507-266-3939

Email: topazian.mark@mayo.edu

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