Here's a series of case studies about double ballon ERCP - not many patients of course, but there have been several other publications that indicate it may be an alternative when traditional ERCP doesn't work.

I think Andrea also posted about this on the main board several months ago. Maybe you could search for that thread. That thread may have more information for you.


Dig Endosc. 2010 Jan;22(1):64-8.

Double balloon endoscope facilitates endoscopic retrograde cholangiopancreatography in roux-en-y anastomosis patients.

Iwamoto S, Ryozawa S, Yamamoto H, Taba K, Ishigaki N, Harano M, Iwano H, Sakaida I.

Source

Department of Gastroenterology and Hepatology, Hikari Municipal Yamato General Hospital, Yamaguchi, Japan.

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard for the treatment of patients with pancreaticobiliary disorders, but endoscopic therapy is very difficult to carry out in patients with a Roux-en-Y anastomosis. We herein present the results of ERCP for patients with a Roux-en-Y anastomosis using a double-balloon endoscope. Six patients (six men with a mean age of 69 years) who had undergone prior gastric resection with Roux-en-Y reconstruction were enrolled in the present study and underwent ERCP and associated procedures. ERCP was carried out with a double balloon endoscope, which has one balloon attached to the tip of the endoscope and another attached to the distal end of the soft overtube. In all patients, entering the Y loop was successfully accomplished, and the papilla of Vater was also reached in all cases (100%). Cannulation was successful in four patients (66.7%). The final diagnosis was choledocholithiasis in two patients, biliary fistula in one patient and pancreatic cancer in one patient. A needle-knife precut papillotomy was carried out after placement of a bile duct stent in two patients, and injection of N-butyl-2-cyanoacrylate into a biliary fistula was carried out in one patient. None of the patients suffered from any complications. A double balloon endoscope is therefore considered to be useful for carrying out ERCP and associated procedures in patients with a Roux-en-Y anastomosis.

Cool beans!

I wonder if there is a limit though, like in my case, with a 200 cm bypass, not to mention the distance from mouth to pouch, is it long enough to "reach"? 

I'll keep this one in mind if my SOD gets bad/intolerable.

Actually, I was thinking about it.... it's been since October that I had an attack.... that is a LOOONG time for me....maybe I'm cured. :-)