Disposable digital percutaneous cholangioscope-aided retrieval of a plastic biliary stent after failed retrieval at ERCP

Post written by Sooraj Tejaswi, MD, MSPH, from the Division of Gastroenterology & Hepatology, University of California Davis School of Medicine, Sacramento, California. We describe the collaborative effort of the use of the novel short cholangioscope-aided percutaneous retrieval of a plastic biliary stent after being unable to retrieve the stent during ERCP. The patient was …

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Nonsurgical rescue after basket-stone impaction by endoscopic cutting of a metallic lithotripter and laser lithotripsy

Post written by Toshiaki Terauchi, MD, from the Department of Surgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan. This report presents a 64-year-old male who underwent successful rescue using a nonsurgical endoscopic approach to remove an impacted mechanical lithotripter basket, due to a 17-mm common bile duct stone. The basket impaction occurred at an outside hospital, and …

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Double high-level disinfection versus liquid chemical sterilization for reprocessing of duodenoscopes used for ERCP

Post written by Mark A. Gromski, MD, from the Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA. This study aimed to answer whether there were any differences in 2 different duodenoscope reprocessing methods that fulfilled supplemental measures to enhance reprocessing: double high-level disinfection and liquid chemical sterilization. …

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EUS-guided jejunojejunostomy to facilitate ERCP in a patient with unique Roux-en-Y gastric bypass anatomy

Post written by Ryan Law, DO, from the University of Michigan, Ann Arbor, Michigan. In our case presentation we describe a patient who presented to our institution with concern for biliary pathology in the setting of prior Roux-en-Y gastric bypass with an indwelling percutaneous biliary drain. Importantly, this patient underwent a sleeve gastrectomy prior to …

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Bilateral balloon expandable biodegradable stent (Y-stent) for postcholecystectomy perihilar biliary stricture

Post written by Sundeep Lakhtakia, MD, DM, and Harsh Vardhan Tevethia, MD, DM, from the Department of Medical Gastroenterology, AIG Hospitals and Asian Institute of Gastroenterology, Hyderabad, Telangana, India. Following complicated laparoscopic cholecystectomy, a young woman developed a biliary stricture that required several ERCP sessions. She presented with recurrent jaundice. MRCP revealed a perihilar stricture …

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EUS-guided choledochoduodenostomy as a rescue after failed ERCP and percutaneous transhepatic biliary drainage in the management of postoperative benign biliary stricture

Post written by Sundeep Lakhtakia, MD, MNAMS, DM, FASGE, from the Department of Medical Gastroenterology, AIG Hospitals and Asian Institute of Gastroenterology, Hyderabad, Telangana, India. A young woman who had surgical choledocho-duodenostomy 5 years ago for biliary adverse events soon after cholecystectomy presented with biliary obstruction. MRCP revealed a smooth mid-CBD stricture, intra-hepatic stone with …

Continue reading EUS-guided choledochoduodenostomy as a rescue after failed ERCP and percutaneous transhepatic biliary drainage in the management of postoperative benign biliary stricture

Early precut versus primary precut sphincterotomy to reduce post-ERCP pancreatitis

Post written by Sudhir Maharshi, MD, DM, and Shyam Sunder Sharma, DNB, DM, from the Department of Gastroenterology, SMS Medical College and Hospitals, Jaipur, India. The focus of our study was to assess the safety and efficacy of primary precut. It is well known that precut sphincterotomy, usually considered after repeated and failed cannulation, is …

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Use of a rigidizing overtube for altered-anatomy ERCP

Post written by Mike Tzuhen Wei, MD, from Stanford University, Stanford, and Veterans Affairs Palo Alto, Palo Alto, California. We present 2 cases in which the rigidizing overtube was used to facilitate performance of altered-anatomy ERCP. In the first case, a 53-year-old woman with history of Roux-en-Y hepaticojejunostomy presented for management of intrahepatic stones. Interventional …

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Gastric overtube use to prevent duodenoscope loop formation during EUS-directed transgastric ERCP procedure

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 …

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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 …

Continue reading Digital single-operator peroral cholangioscopy-guided biopsy sampling versus ERCP-guided brushing for indeterminate biliary strictures