論文種別	総説
言語種別	英語
査読の有無	その他(不明)
表題	Balloon-assisted ERCP for bile duct stones in surgically altered anatomy: current techniques, devices, and evolving strategies.
掲載誌名	正式名：Therapeutic advances in gastroenterology 略　 称：Therap Adv Gastroenterol ISSNコード：1756283X/1756283X
掲載区分	国外
巻・号・頁	18,pp.17562848251387600
著者・共著者	Haruka Toyonaga, Makoto Masaki, Arata Oka, Hidetoshi Nakata, Shoji Takayama, Tatsuya Nakagawa, Takuya Takayama, Masahiro Orino, Hironao Matsumoto, Takeshi Yamashina, Masaaki Shimatani
発行年月	2025/10
概要	Balloon endoscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP) has become an essential modality for managing pancreaticobiliary diseases in patients with surgically altered anatomy (SAA). This review summarizes the current evidence and technical advances in BE-ERCP, with a focus on insertion strategies tailored to specific reconstructive surgical techniques. Recent developments in short-type balloon endoscopes have improved maneuverability and device compatibility, enabling the widespread use of standard ERCP accessories. In addition, innovative tools, such as highly rotatable sphincterotomes, helical stone retrieval baskets, and newly introduced slim cholangioscopes, have expanded the diagnostic and therapeutic potential of BE-ERCP. Papillary interventions, including endoscopic sphincterotomy, endoscopic papillary balloon dilation (EPBD), large balloon dilation (EPLBD), and combined approaches (ESBD), are discussed with respect to their feasibility and safety in SAA. Furthermore, the clinical efficacy of stone removal and lithotripsy techniques, including peroral cholangioscopy-guided electrohydraulic lithotripsy, is reviewed. Finally, we address the emerging role of interventional endoscopic ultrasound as a complementary or alternative strategy to BE-ERCP. Taken together, this review provides a comprehensive update on current techniques and evolving strategies for endoscopic management of bile duct stones in patients with altered anatomy.
DOI	10.1177/17562848251387600
PMID	41179488