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ObjectiveTo investigate the clinical effect and safety of balloon-assisted enteroscopy combined with endoscopic retrograde cholangiopancreatography (ERCP) in patients with altered gastrointestinal anatomy. MethodsA total of 12 patients who were admitted to General Hospital of Beijing Military Region from April 2016 to October 2017 and underwent balloon-assisted ERCP after surgical alteration of gastrointestinal anatomy were enrolled, among whom 4 underwent choledochoenterostomy and 8 underwent pancreaticoduodenectomy. Double-balloon enteroscopy was performed for 4 patients and single-balloon enteroscopy was performed for 8 patients. A retrospective analysis was performed for treatment outcome, complications, and prognosis. ResultsA total of 10 patients underwent balloon-assisted ERCP successfully, resulting in an overall success rate of 83.3%, and among these patients, 2 had simple anastomotic stenosis and 8 had anastomotic stenosis and intrahepatic bile duct stones. Among the two patients who did not complete ERCP, one had severe anastomotic stenosis which prevented the guide wire from entering the bile duct, and the other patient had a small angle of R-Y intestinal anastomosis which prevented the lens and the cannula from entering the afferent loop. After surgery, one patient experienced jaundice and one experienced perforation of the gastrointestinal tract, resulting in an incidence rate of complications of 16.7%, and both patients were cured after conservative treatment. ConclusionBalloon-assisted ERCP has good safety and a marked clinical effect with unique complications, as well as a lower success rate than conventional ERCP.

ObjectiveTo analyze the clinical characteristics of patients treated with multiple therapeutic endoscopic retrograde cholangiopancreatography (ERCP) procedures and to evaluate the causes, safety, and efficacy of repeated ERCP. MethodsAnalyses of therapeutic results, complications, and postoperative outcomes were performed on the clinical data of the patients who were admitted to Beijing Army General Hospital and received ERCP at least twice from July 2010 to December 2014. ResultsSeventy-seven patients underwent 187 times of ERCP procedures in total, among which 2 times were performed in 60 patients, 3 times in 6 patients, 4 times in 8 patients, 5 times in 2 patients, and 7 times in 1 patient. Postoperative events included hemorrhea after endoscopic sphincterotomy in 2 cases, post-ERCP pancreatitis in 2 cases, duodenal perforation in 1 case, and death within 3 weeks after ERCP in 2 cases due to chronic obstructive pulmonary disease. ConclusionRecurrent common bile duct stones, inflammatory stenosis of the bile duct, chronic pancreatitis, and prolonged survival of malignant tumor patients are the main reasons for repeated ERCP. The patients aged over 80 years are more likely to undergo multiple ERCP procedures. Repeated ERCP shows good overall safety and efficacy.

Objective To analyze the clinical characteristics of patients aged equal to or more than 80 years receiving multiple endoscopic retrograde cholangiopancreatography (ERCP) procedures and to evaluate the safety and efficacy of ERCP. Methods The clinical data were collected and retrospectively reviewed for patients aged 80 years or older who were admitted to the Gastroenterology Department of Beijing Army General Hospital and underwent ERCP at least twice from July 2010 to December 2014. Results Sixty patients (male 33, female 27) underwent 146 times of ERCP in total, among which 2 times were performed in 47 patients, 3 times in 5 patients, 4 times in 5 patients, 5 times in 2 patients, and 7 times in 1 patient. Postoperative events included hemorrhea after endoscopic sphincterotomy in 2 cases, post-ERCP acute pancreatitis in 1 case, and death within 3 weeks after ERCP in 2 cases due to chronic obstructive pulmonary disease. Conclusion Recurrent common bile duct stones and prolonged survival time of malignant tumor patients are the main reasons for repeated ERCP in elderly patients. As a whole, ERCP shows good safety and efficacy and improves the prognosis in elderly patients with biliopancreatic disorders.

ObjectiveTo investigate the cause and treatment of delayed hemobilia after endoscopic retrograde cholangiopancreatography (ERCP). MethodsA retrospective analysis was performed on the complications in 1007 patients after ERCP, and the 7 cases of delayed hemobilia were subjected to analysis of time of onset of bleeding, spectrum of disease, blood volume, and treatment process. ResultsAll the bleeding patients had cholangitis. The bleeding occurred at 24 hours to 2 weeks after ERCP, with a small to medium volume of blood (≤1000 ml). The conservative medical treatment produced a good outcome in these bleeding patients. ConclusionDelayed hemobilia after ERCP is rare and has a good prognosis following conservative medical treatment.