Post written by Shelini Sooklal, MD, from the Division of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic Foundation, Cleveland, Ohio, USA. This video case demonstrates the technique of using a disposable gastric overtube device to aid passage of the duodenoscope through a previously placed lumen apposing metal stent (LAMS), from the roux limb to the remnant …
Tag: ERCP
Digital single-operator peroral cholangioscopy-guided biopsy sampling versus ERCP-guided brushing for indeterminate biliary strictures
Post written by Mohan Ramchandani, MD, from the Asian Institute of Gastroenterology Hospitals, Hyderabad, India. The aim of this study was to assess the diagnostic accuracy of digital single-operator cholangioscopy (DSOC) compared with ERCP-based assessment using traditional sampling technology in patients with indeterminate biliary strictures (IBS). Indeterminate biliary stricture was defined as a suspected intrinsic …
Type VI choledochal cyst diagnosed on ERCP with direct cholangioscopy
Post written by Lawrence Ku, MD, from the Division of Gastroenterology, Harbor-UCLA Medical Center, Torrance, California, USA. This case highlights the diagnostic dilemma of differentiating between 2 types of choledochal cysts, type II versus type VI. Although rare, these choledochal cysts have significant malignant potential, ranging from 5 to 7.5%. Malignant transformation of type VI …
Continue reading Type VI choledochal cyst diagnosed on ERCP with direct cholangioscopy
Electrohydraulic lithotripsy through a fistula of EUS-guided hepaticogastrostomy
Post written by Tatsuya Sato, MD, Yousuke Nakai, MD, PhD, from the Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. A 50-year-old man with a history of hepaticojejunostomy and Roux-en-Y reconstruction suffered from recurrent cholangitis due to bilateral intrahepatic stones. After failed double-balloon endoscope-assisted ERCP and percutaneous transhepatic biliary drainage, …
Continue reading Electrohydraulic lithotripsy through a fistula of EUS-guided hepaticogastrostomy
Endotracheal anesthesia vs monitored anesthesia care and sedation-related adverse events during ERCP
Post written by Zachary L. Smith, DO, from the Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA. The focus of this study was to evaluate the use of general endotracheal anesthesia (GEA) versus monitored anesthesia care (MAC) during ERCP in high-risk patients. Historically, our institution sedated the vast majority of patients …
Rescue of a delayed spontaneously migrated lumen-apposing metal stent placed to facilitate transluminal ERCP
Post written by Prabhleen Chahal, MD, FACG, FASGE, and C. Roberto Simons-Linares, MD, MSc, from the Gastroenterology and Hepatology Department, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. We present a case of a delayed spontaneously migrated lumen-apposing metal stent (LAMS) that was placed in a patient with a history of Roux-en-Y gastric bypass …
Editor’s Choice: GEA vs MAC in high-risk patients undergoing ERCP
GIE Associate Editor, Dr. Sharmila Anandasabapathy, highlights this article from the April issue “A randomized controlled trial evaluating general endotracheal anesthesia versus monitored anesthesia care and the incidence of sedation-related adverse events during ERCP in high-risk patients” by Zachary L. Smith, DO, et al. This is one of the few studies which compare, via a randomized …
Continue reading Editor’s Choice: GEA vs MAC in high-risk patients undergoing ERCP
In vivo diagnosis of intraductal papillary mucinous neoplasm with per-oral pancreatoscopy–guided confocal laser endomicroscopy
Post written by Yuki Tanisaka, MD, PhD, from the Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan. Our patient was a 79-year-old man in whom computed tomography indicated expansion of the main pancreatic duct. Endoscopic ultrasound (EUS) showed expansion of the entire pancreatic duct but could not detect the villous protrusions. Endoscopic …
Successful liver-directed gene delivery by ERCP-guided hydrodynamic injection
Post written by Vivek Kumbhari, MD, from the Department of Medicine and Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA. The success of gene-targeted therapy depends on 2 fundamental steps; the first being the intracellular delivery and the second is the genetic modification of the target cells. The first step …
Continue reading Successful liver-directed gene delivery by ERCP-guided hydrodynamic injection
Excavation of a fossilized biliary stent
Post written by Brian S. Lim, MD, MCR, FASGE, from the School of Medicine, University of California, and the Department of Gastroenterology, Kaiser Permanente Riverside Medical Center, Riverside, California, USA. A 60-year-old male presented with right lower-quadrant pain and fever. CT (computed tomography) abdomen showed acute appendicitis, but also an incidental biliary stent. The atient …
