ERCP and sphincterotomy after Billroth II gastrectomy

Endoscopic retrograde cholangiopancreatography (ERCP) procedures are more difficult in patients who have undergone partial gastrectomy with Billroth II anastomosis. Results improve with experience; we have achieved full diagnostic information in only 52% of 63 attempts, but ultimately in 60% of the 53 patients concerned. Therapeutic endeavours were more successful with useful results in eight of 10 patients during the last two years. Alternative diagnostic and therapeutic techniques should be used wherever possible in these patients.