This platform allows for use of the larger (≥3.7 mm) working channel and hence enhanced therapeutic capability. Our aims were to determine the diagnostic yield, therapeutic yield and safety of TSBC for deep enteroscopy in patients with surgically altered anatomy. Methods: We performed a retrospective, single-centre study of consecutive deep enteroscopies

using TSBC. Cases with surgically altered anatomy and a variety of indications were reviewed. Patients that underwent altered anatomy ERCP were also included. Patient demographics and clinical data were obtained, and procedural Dasatinib in vitro interventions and complications recorded. Diagnostic yield was defined as percentage of exams where a specific diagnosis was made. Therapeutic

yield was defined as percentage of exams where an intervention was successfully performed. Adverse events were graded according to the ASGE lexicon’s severity grading system. Results: A total of 41 consecutive cases using the TSBC for deep enteroscopy were performed; 13 of which had surgically altered anatomy. The selleck most common type of altered anatomy was Roux-en-Y gastric bypass (n = 9). All cases were anterograde enteroscopies performed with fluoroscopic guidance. The most common indication was evaluation of stricture or partial small bowel obstruction (n = 6). Others included suspected choledocholithiasis (n = 4), obscure bleeding (n = 1), melena (n = 1), removal of biliary stent (n = 1). The diagnostic yield was 69% (9/13). The therapeutic yield was 62% (8/13). In 3/9 successful cases, the intervention (two enteral stent placements and one metal

biliary stent deployment) could not have been accomplished with mainstream enteroscopy platforms. Additional therapies included metal biliary stent removal through the working channel of the endoscope and two patients with obscure GI bleeding were treated successfully (one with APC and the other with endovlips). One adverse event was recorded in which the TSBC ruptured mafosfamide while navigating a tight stricture. The catheter was retracted and replaced and the procedure continued. Conclusion: The TSBC in altered anatomy enteroscopy appears efficacious and safe in these challenging patients. The TSBC platform allows for a broader range of therapeutic capabilities due to the larger calibre working channel which facilitates the deployment of metal biliary and enteral stents. V KUMBHARI,1 P SAXENA,1 AH TIEU,1 M ONIMARU,2 M EL ZEIN,1 RJ MODAYIL,3 EN TEITELBAUM,4 AA MESSALLEM,1 ME GITELIS,5 SN STAVROPOULOS,3 ES HUNGNESS,4 MB UJIKI,5 H SHIWAKU,6 PW CHIU,7 H INOUE,2 MA KHASHAB1 1Department of Medicine and Division of Gastroenterology and Hepatology, John Hopkins Hospital and Medical Institution.