Sliding tube-assisted ERCP in a patient who underwent double tract reconstruction anatomy after proximal gastrectomy

For patients with surgically altered gastrointestinal anatomy, the difficulty of performing endoscopic retrograde cholangiopancreatography (ERCP) has been reported [1] [2] [3]. After proximal gastrectomy, double tract reconstruction is usually performed (PG-DT), and some patients with PG-DT require ERCP. Although a technique of guidewire-assisted side-viewing scope insertion for patients with PG-DT has been reported [4], the bent and tortuous nature of the interstitial jejunum and the end-to-side anastomosis of the gastric jejunum make it difficult ([Fig. 1]).