{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T04:28:19Z","timestamp":1786681699005,"version":"build-2736575974"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2027,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Endoscopic retrograde cholangiopancreatography (ERCP) in patients with situs inversus totalis (SIT) and Billroth II reconstruction is technically challenging because of mirror\u2010image anatomy, altered access to the papilla, and inverted papillary orientation. A 56\u2010year\u2010old man with a history of distal gastrectomy with Billroth II reconstruction for a gastric ulcer 20 years earlier was found to have common bile duct stones on pre\u2010ERCP imaging. ERCP was performed in the prone position, as in conventional ERCP, with the endoscopist standing on the patient's right side. A short\u2010type single\u2010balloon enteroscope was advanced through the afferent limb to the major papilla. Biliary cannulation was achieved using a standard ERCP catheter without positional modification or sphincterotome. Cholangiography confirmed small common bile duct stones. Endoscopic papillary balloon dilation with an 8\u2010mm balloon was performed, followed by stone extraction using a basket catheter. Final cholangiography confirmed complete stone clearance, and no adverse events, including post\u2010ERCP pancreatitis, occurred. This case suggests that favorable alignment between the 7 o'clock working\u2010channel direction and the bile duct axis may allow conventional\u2010position ERCP in selected patients with SIT and Billroth II reconstruction.<\/jats:p>","DOI":"10.1002\/deo2.70403","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T03:55:31Z","timestamp":1786679731000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Balloon Enteroscopy\u2010assisted Endoscopic Retrograde Cholangiopancreatography for Choledocholithiasis in Situs Inversus Totalis With Billroth II Reconstruction: A Case Report and Literature Review"],"prefix":"10.1002","volume":"7","author":[{"given":"Shuhei","family":"Shintani","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Shiga University of Medical Science Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunya","family":"Oi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Shiga University of Medical Science Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyohiro","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Shiga University of Medical Science Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erina","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Shiga University of Medical Science Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriaki","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Shiga University of Medical Science Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Nishida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Shiga University of Medical Science Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuji","family":"Iwashita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Shiga University of Medical Science Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"issue":"6","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1148\/rg.226025016","article-title":"Abdominal Manifestations of Situs Anomalies in Adults","volume":"22","author":"Ann S.","year":"2002","journal-title":"Radiographics"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"2437","DOI":"10.2147\/IJGM.S295444","article-title":"Situs Inversus Totalis: A Clinical Review","volume":"15","author":"Eitler K.","year":"2022","journal-title":"International Journal of General Medicine"},{"issue":"1","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1186\/s12876-022-02593-3","article-title":"Efficacy and Safety of ERCP in Patients With Situs Inversus Totalis: Multicenter Case Series and Literature Review","volume":"22","author":"Ding B.","year":"2022","journal-title":"BMC Gastroenterology"},{"issue":"02","key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"E316","DOI":"10.1055\/s-0030-1255813","article-title":"ERCP in Complete Situs Inversus Viscerum Using a \u201cMirror Image\u201d Technique","volume":"42","author":"Garc\u00eda\u2010Fern\u00e1ndez F.","year":"2010","journal-title":"Endoscopy"},{"issue":"1","key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"118","DOI":"10.5009\/gnl14330","article-title":"Successful Stone Removal by Endoscopic Retrograde Cholangiopancreatography in Situs Inversus Totalis With Billroth\u2010II Gastrectomy","volume":"9","author":"Kim S. B.","year":"2015","journal-title":"Gut and Liver"},{"issue":"01","key":"e_1_2_9_7_1","first-page":"E46","article-title":"Double\u2010Balloon Enteroscopy\u2010Assisted ERCP in Situs Inversus With Roux\u2010en\u2010Y Hepaticojejunostomy for Complex Anastomotic Stricture Dilated With Soehendra Stent Retriever","volume":"49","author":"Inoue T.","year":"2017","journal-title":"Endoscopy"},{"issue":"6","key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1002\/jgh3.12163","article-title":"Successful Endoscopic Retrograde Cholangiopancreatography Using Pancreatic Guidewire Placement for Biliary Cannulation in a Patient With Situs Inversus and Billroth\u2010I Gastrectomy (With Video)","volume":"3","author":"Tanisaka Y.","year":"2019","journal-title":"JGH Open"},{"issue":"01","key":"e_1_2_9_9_1","first-page":"E304","article-title":"To Twist or Not to Twist: A Case of ERCP in Situs Inversus Totalis","volume":"46","author":"Patel K.","year":"2014","journal-title":"Endoscopy"},{"issue":"09","key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"E333","DOI":"10.1055\/a-1122-8416","article-title":"Successful Biliary Cannulation Using a Novel Rotatable Sphincterotome in a Patient With Situs Inversus Totalis","volume":"52","author":"Yoshida A.","year":"2020","journal-title":"Endoscopy"},{"issue":"8","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.vgie.2021.05.002","article-title":"A Rotary Papillotome plus Adjustment of the Monitor Position to the Foot Side Helps Facilitate ERCP in a Patient With Situs Inversus Totalis","volume":"6","author":"Zennyoji D.","year":"2021","journal-title":"VideoGIE"}],"container-title":["DEN Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70403","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/deo2.70403","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70403","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T03:55:33Z","timestamp":1786679733000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/deo2.70403"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2027,4]]}},"alternative-id":["10.1002\/deo2.70403"],"URL":"https:\/\/doi.org\/10.1002\/deo2.70403","archive":["Portico"],"relation":{},"ISSN":["2692-4609","2692-4609"],"issn-type":[{"value":"2692-4609","type":"print"},{"value":"2692-4609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]},"assertion":[{"value":"2026-06-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70403"}}