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目的:评估毕Ⅱ式胃大部切术后经内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography, ERCP)的有效性和安全性。方法:回顾性分析2013年1月—2018年12月在西京消化病医院内镜中心接受ERCP诊治的67例毕Ⅱ式胃大部切除术后患者的临床资料。根据胃大部切除术时是否加做布朗吻合分为布朗吻合组和非布朗吻合组。根据使用内镜不同，将患者分为十二指肠镜组、常规前视镜组和气囊辅助式小肠镜组。分析ERCP成功率和不良事件的发生率。结果:67例患者接受了82例次ERCP诊治。毕Ⅱ式胃大部切除术后ERCP的插镜成功率、诊断成功率、治疗成功率和ERCP成功率分别为90.2%(74/82)、87.8%(65/74)、100.0%(65/65)和79.3%(65/82)。非布朗吻合和布朗吻合患者的ERCP成功率分别为79.7%(47/59)和78.3%(18/23)。十二指肠镜组、常规前视镜组和气囊辅助式小肠镜组的ERCP成功率分别为93.8%(15/16)、76.2%(48/63)和2/3。常规前视镜使用和不使用透明帽辅助的ERCP成功率分别为80.8%(42/52)和54.5%(6/11)。患者均未发生不良事件。结论:毕Ⅱ式胃大部切除术后ERCP是有效和安全的。小肠镜可以作为十二指肠镜和常规前视镜操作失败后的一种候选方法。当使用常规前视镜操作时，用透明帽辅助可提高ERCP成功率。“,”Objective:To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) for patients after Billroth Ⅱ gastrectomy.Methods:Data of 67 patients after Billroth Ⅱ gastrectomy who underwent ERCP at endoscopic center of Xijing Hospital of Digestive Diseases from January 2013 to December 2018 were retrospectively analyzed. Patients were firstly divided into Braun-anastomosis group and non-Braun-anastomosis group. They were also divided into duodenoscopy group, conventional forward-viewing endoscopy group and balloon-assisted enteroscopy group according to endoscopic selection. The rates of ERCP success and adverse events were analyzed.Results:A total of 82 ERCP procedures were performed on 67 patients. The cannulation success rate, diagnostic success rate, therapeutic success rate and ERCP success rate in patients after Billroth Ⅱ gastrectomy were 90.2% (74/82), 87.8% (65/74), 100.0% (65/65) and 79.3% (65/82), respectively. The ERCP success rates in patients with non-Braun-anastomosis and Braun-anastomosis were 79.7% (47/59) and 78.3% (18/23), respectively. The ERCP success rates of duodenoscopy group, conventional forward-viewing endoscopy group and balloon-assisted enteroscopy group were 93.8% (15/16), 76.2% (48/63) and 2/3, respectively. ERCP success rates of conventional forward-viewing endoscopy with and without transparent cap were 80.8% (42/52) and 54.5% (6/11), respectively. No adverse events occurred in any patient.Conclusion:ERCP after Billroth Ⅱ gastrectomy is effective and safe. Balloon-assisted enteroscopy can be an option after the failure of duodenoscopy and conventional forward-viewing endoscopy. ERCP success rate can probably be improved with the aid of transparent cap when conventional forward-viewing endoscope is used.