Vascularity can distinguish neoplastic from non-neoplastic bile duct lesions during digital single-operator cholangioscopy

Post written by Carlos Robles-Medranda, MD, from the Gastroenterology and Endoscopy, Instituto Ecuatoriano de Enfermedades Digestivas, Guayaquil, Ecuador. Accurately diagnosing indeterminate biliary lesions on clinical practice is a challenging task. Endoscopists may use Digital single operator cholangioscopy (DSOC) to evaluate those lesions, acquire histologic specimens, and to guide clinical management. Various DSOC classification systems and …

Continue reading Vascularity can distinguish neoplastic from non-neoplastic bile duct lesions during digital single-operator cholangioscopy

Overtube-guided electrohydraulic lithotripsy through digital cholangioscopy for difficult biliary stones in a postoperative patient

Post written by Hassan Atalla, MSc, and Arata Sakai, MD, PhD, from the Hepatology and Gastroenterology Unit, Department of Internal Medicine, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt, and the Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. A 60-year-old man with history of Roux-en-Y hepaticojejunostomy for …

Continue reading Overtube-guided electrohydraulic lithotripsy through digital cholangioscopy for difficult biliary stones in a postoperative patient

Single-operator peroral cholangioscopy cystic duct cannulation for transpapillary gallbladder stent placement

Post written by Wiriyaporn Ridtitid, MD, Panida Piyachaturawat, MD, and Rungsun Rerknimitr, MD, from the Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross, Bangkok, Thailand. The focus of our study was to determine the efficacy and safety of single-operator peroral cholangioscopy (SOC) for helping …

Continue reading Single-operator peroral cholangioscopy cystic duct cannulation for transpapillary gallbladder stent placement

Removal of proximally migrated biliary stents by using single-operator cholangioscopy

Post written by Abed Al Lehibi, MD, from Gastroenterology and Hepatology, King Fahad Medical City, Riyadh, Saudi Arabia. Our series included 3 patients whose cases, while being treated for difficult biliary stones, were complicated by proximal stent migration. Two patients had migrated plastic stents, whereas the other had a migrated metal one. Single-operator cholangioscopy (Boston …

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Peroral cholangioscopy–guided probe-based confocal laser endomicroscopy for preoperative diagnosis of pancreatic cancer

Post written by Yuki Tanisaka, MD, PhD, from the Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan. A 79-year-old man was referred to our hospital because of jaundice. He had previously undergone Billroth-II gastrectomy for gastric cancer. ERCP was performed. At first, we used a SIF-H290S (Olympus Medical Systems, Tokyo, Japan) with …

Continue reading Peroral cholangioscopy–guided probe-based confocal laser endomicroscopy for preoperative diagnosis of pancreatic cancer

Stent-in-stent self-expandable metallic stent placement under direct cholangioscopy

Post written by Mitsuru Okuno, MD, PhD, from the Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan. Managing consequent jaundice caused by malignant hilar biliary obstruction (MHBO) is important. Endoscopic biliary drainage is the treatment of choice because of its limited invasiveness. However, in patients with surgically altered anatomy, especially those who have undergone Roux-en-Y …

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A case of hemobilia secondary to cancer of the gallbladder confirmed by cholangioscopy

Post written by Linda Zhang, MBBS, from the Department of Gastroenterology and Hepatology, St George Hospital, Kogarah, Australia. This article discusses the management of hemobilia due to gallbladder malignancy in a frail, elderly patient with multiple comorbidities, which limited the available therapies. Our patient was a 90-year-old female who presented with biliary obstruction and melaena. …

Continue reading A case of hemobilia secondary to cancer of the gallbladder confirmed by cholangioscopy

Balloon overtube-assisted cholangioscopy and laser lithotripsy of large bile duct stones

Post written by Jaehoon Cho, MD, and Ara B. Sahakian, MD, from the Department of Internal Medicine, Los Angeles County Hospital and University of Southern California Medical Center, and the Division of Gastrointestinal and Liver Diseases, University of Southern California Keck School of Medicine, Los Angeles, California, USA. In this video, we describe successful balloon …

Continue reading Balloon overtube-assisted cholangioscopy and laser lithotripsy of large bile duct stones

Electrohydraulic lithotripsy under double-balloon endoscope–assisted direct cholangioscopy

Post written by Tatsuya Sato, MD, from the Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. This is a case report of double-balloon endoscope-assisted direct cholangioscopy in a patient with a history of total gastrectomy and Roux-en-Y (R-Y) reconstruction. Electrohydraulic lithotripsy (EHL) was necessary to remove large and multiple bile …

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Digital cholangioscopic evaluation of a post–liver transplantation stricture

Post written by Shyam Menon, MSc, MD, FRCP, from the Department of Liver Medicine, University Hospitals Birmingham, NHS Foundation Trust, Birmingham, United Kingdom. Post liver transplantation anastomotic strictures can be technically challenging to manage. We describe a patient who presented a few months after liver transplantation with progressively deteriorating liver function tests and an episode …

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