Successful endoscopic retrograde cholangiopancreatography using pancreatic guidewire placement for biliary cannulation in a patient with situs inversus and Billroth-I gastrectomy (with video)

Yuki Tanisaka; Shomei Ryozawa; Kosuke Sudo; Akashi Fujita; Masafumi Mizuide; Kouichi Nonaka; Tomoaki Tashima

doi:10.1002/jgh3.12163

Successful endoscopic retrograde cholangiopancreatography using pancreatic guidewire placement for biliary cannulation in a patient with situs inversus and Billroth-I gastrectomy (with video)

JGH Open. 2019 Feb 20;3(6):540-541. doi: 10.1002/jgh3.12163. eCollection 2019 Dec.

Authors

Yuki Tanisaka¹, Shomei Ryozawa¹, Kosuke Sudo², Akashi Fujita¹, Masafumi Mizuide¹, Kouichi Nonaka¹, Tomoaki Tashima¹

Affiliations

¹ Department of Gastroenterology Saitama Medical University International Medical Center Hidaka Saitama Japan.
² Department of Gastroenterology Southern Tohoku General Hospital Iwanuma, Miyagi Japan.

Abstract

We reported a 95-year-old man with cholangitis who underwent Billroth-I gastrectomy. He was diagnosed with situs inversus viscerum and ERCP was performed. A stable field of view could not be secured due to anatomical factors (Billroth-I gastrectomy) and strong respiratory variations. However, pancreatic duct cannulation was possible. A pancreatic guidewire was placed to achieve selective biliary cannulation. This stabilized the field of view. The catheter was inserted on the right side of the guidewire. Cannulation to the 1 o'clock direction achieved biliary cannulation. Intended procedure was completed safely in the present case.

Keywords: Billroth‐I gastrectomy; ERCP; pancreatic guidewire placement for biliary cannulation; situs inversus.

Publication types

Case Reports