Peroral jejunoscopy for treating stenosis of hepaticojejunostomy after pancreatoduodenectomy

A 72-year-old woman suffered from relapsing cholangitis after pylorus-prese rving pancreatoduodenectomy for chronic pancreatitis. The common hepatic du ct had been anastomosed to the jejunum 8cm distal to the duodenojejunostomy . Peroral jejunoscopy showed a severe stenosis of the hepaticojejunostomy, which was endoscopically enlarged by means of electroincision and balloon d ilation, subsequently. No procedure-related complications occurred. The pat ient has been asymptomatic for 34 months. Most of the strictures of bilioen terostomy are reportedly treated by surgical revision, the percutaneous tra nshepatic approach, or the percutaneous transjejunal approach. Endoscopic t reatment may be attempted in cases in which the postoperative anatomy poten tially allows endoscopic access, because of its minimal invasiveness and ef fectiveness.