Cholecystoduodenostomy for Balloon-assisted ERCP-related Jejunal Perforation in a Patient with Roux-en-Y Reconstruction

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  • 胃全摘術Roux-en-Y再建後のバルーン内視鏡を用いたERCPに伴う小腸穿孔の1例
  • イ ゼンテキジュツ Roux-en-Y サイケン ゴ ノ バルーン ナイシキョウ オ モチイタ ERCP ニ トモナウ ショウチョウ センコウ ノ 1レイ

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Abstract

<p>Balloon-assisted endoscopic retrograde cholangiopancreatography (BAERCP) has been widely performed in recent years for patients with common bile duct stones after Roux-en-Y reconstruction. However, accidental bowel perforation caused by BAERCP could necessitate emergency surgery. Herein, we describe the case of an 86-year-old Japanese woman who was diagnosed as having jaundice caused by a common bile duct stone 19 years after a total gastrectomy and Roux-en-Y reconstruction for gastric cancer. The patient underwent ERCP by double-balloon enteroscopy. However, we found a deep laceration in the jejunum soon after the procedure. Because she had abdominal pain with signs of peritoneal irritation, we performed emergency operation, closure of the perforation, and cholecystoduodenostomy. The patient was discharged 22 days after the operation. Herein, we report the efficacy of cholecystoduodenostomy combined with suture of the perforation in a patient with obstructive jaundice caused by a common bile duct stone and iatrogenic bowel perforation caused by BAERCP.</p>

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