Feasibility of Roux-en-Y Loop Enteroscopy in Children with Liver Disease

Abstract

AIM: The Roux loop is a common technique used in reconstructive biliary surgery, which diverts bile flow into the proximal jejunum. It may be a source of problems postoperatively such as cholangitis due to stenosis or anastomotic bleeding, which can be difficult to diagnose by conventional endoscopic techniques. In adults, the Roux loop has been accessed using balloon enteroscopes and we now report our experience of using the single and double balloon enteroscopes in children with liver disease.

METHODS: Retrospectively reviewed the number of children (under the age of 16 years) whom have had Roux-en-Y loop enteroscopy after having reconstructive surgery at King’s College Hospital prior to December 2011. All procedures were performed under general anesthesia under fluoroscopic control. Single balloon enteroscope (Olympus SIF type Q260) and outer tube (Olympus ST-SB1-length 140cm and double balloon enteroscope (EN-450T5) and outer tube TS-13140 (Fujinon) were used in this study.

RESULTS: Total of 3 patients, 2 males and 1 female patient were identified. Two procedures were performed using single balloon enteroscope and one was using double balloon enteroscope. Rouxen-Y loop enteroscopy was successful among all three patients using single or double balloon enteroscopy. Procedures were uncomplicated and patients were discharged without any problems.

CONCLUSIONS: RNY loop examination is possible after small bowel reconstructive surgery in children and this could be attempted in specialised centres prior to considering surgical intervention; using single or double balloon enteroscope and this could potentially avoid the need for surgery.