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

AIM: The Roux loop is a common technique used in reconstructivebiliary surgery, which diverts bile flow into the proximal jejunum.It may be a source of problems postoperatively such as cholangitisdue to stenosis or anastomotic bleeding, which can be difficult todiagnose by conventional endoscopic techniques. In adults, theRoux loop has been accessed using balloon enteroscopes and wenow report our experience of using the single and double balloonenteroscopes in children with liver disease.METHODS: Retrospectively reviewed the number of children (underthe age of 16 years) whom have had Roux-en-Y loop enteroscopyafter having reconstructive surgery at King’s College Hospital priorto December 2011. All procedures were performed under generalanesthesia under fluoroscopic control. Single balloon enteroscope(Olympus SIF type Q260) and outer tube (Olympus ST-SB1-length140cm and double balloon enteroscope (EN-450T5) and outer tubeTS-13140 (Fujinon) were used in this study.RESULTS: Total of 3 patients, 2 males and 1 female patient wereidentified. Two procedures were performed using single balloonenteroscope and one was using double balloon enteroscope. Rouxen-Y loop enteroscopy was successful among all three patients usingsingle or double balloon enteroscopy. Procedures were uncomplicatedand patients were discharged without any problems.CONCLUSIONS: RNY loop examination is possible after smallbowel reconstructive surgery in children and this could be attemptedin specialised centres prior to considering surgical intervention; usingsingle or double balloon enteroscope and this could potentially avoidthe need for surgery.