Post written by Thomas Tielleman, MD, from the University of Texas Southwestern Medical Center, Dallas, Texas, USA. This is a case of a 48-year-old man who underwent cholecystectomy complicated by hemoperitoneum requiring take-backs to the operating room. A complete bile duct transection ultimately complicated the surgeries. Cholangiography from ERCP and percutaneous transhepatic cholangiography confirmed a large …
Tag: ERCP
EUS-guided enteroenterostomy to facilitate peroral altered anatomy ERCP
Post written by Romik P. Srivastava, MD, from the Medical University of South Carolina, Charleston, South Carolina, USA. In our video series, we present 4 cases of patients with non—gastric bypass altered anatomy who required complex ERCP. To facilitate peroral ERCP using a therapeutic gastroscope or duodenoscope, we created an EUS-guided enteroenterostomy in order to shorten …
Continue reading EUS-guided enteroenterostomy to facilitate peroral altered anatomy ERCP
Two clues make a proof: EUS-directed transgastric ERCP in twice-surgically altered anatomy—Roux-en-Y gastric bypass conversion of a sleeve gastrectomy
Post written by Giuseppe Vanella, MD, from the Pancreatobiliary Endoscopy and Endosonography Division, IRCCS San Raffaele Institute, Milan, Italy. In the realm of endoscopy, the advent of lumen-apposing metal stents (LAMSs) has paved the way for innovative solutions to challenges once considered insurmountable. One such breakthrough is the technique known as EUS-directed transgastric ERCP (EDGE), which …
Clip-and-line traction method for difficult ERCP cannulation due to choledochocoele
Post written by Mark Henrik Bonnichsen, MBBS (Hon), from the Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore. We describe a case of a 77-year-old woman who underwent ERCP for choledocholithiasis and surveillance MRCP for an intraductal papillary mucinous neoplasm. MRCP also showed an incidental choledochocoele. At ERCP, the choledochocoele made visualization of the …
Continue reading Clip-and-line traction method for difficult ERCP cannulation due to choledochocoele
Clinical outcomes and learning curve for ERCP during advanced endoscopy training: a comparison of supine versus prone positioning
Post written by Danny Issa, MD, from UCLA, Los Angeles, California, USA. This study explores the clinical outcomes of ERCP in the supine versus prone patient position when performed by a trainee. Studies have reported variable outcomes of ERCP in each position. In the United States, the majority of ERCPs are performed in prone positions. Nevertheless, …
Transjejunal ERCP, EUS-guided gallbladder drainage, and cholecystoscopy with direct electrohydraulic lithotripsy with large gallstone removal in Roux-en-Y anatomy
Post written by Arjun Chatterjee, MD, from the Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA. A 61-year-old man presented with intermittent right-upper-quadrant pain, nausea, and vomiting. A CT scan of his abdomen revealed choledocholithiasis and large cholelithiasis. His medical and surgical history included severe obesity, Roux-en-Y gastric bypass, bowel perforation with extensive resection, …
Helix tack for lumen-apposing metal stent fixation in single-session EUS-directed transgastric ERCP
Post written by Kambiz S. Kadkhodayan, MD, from the Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA. We describe the use of a helix tack system to anchor the proximal flange of a lumen-apposing metal stent (LAMS) to the gastric pouch during a single-session EUS-directed transgastric ERCP (SS-EDGE). This video case also describes a reverse …
Performance of single-use duodenoscopes for ERCP: a systematic review and meta-analysis
Post written by Harishankar Gopakumar, MD, FACP, from the Division of Gastroenterology, Hepatology and Nutrition, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA. This study is a systematic review and meta-analysis of the performance characteristics, safety profile, and overall endoscopist satisfaction with single-use fully disposable duodenoscopes. Transmission of exogenous pathogens during ERCP using …
With a little help from my friends: percutaneously assisted internalization of a biliary drain
Post written by Jad AbiMansour, MD, from the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA. We present the use of a preexisting percutaneous transhepatic biliary drain to distend the left biliary system and facilitate the completion of EUS-guided hepaticogastrostomy (EUS-HG), successfully internalizing the drain. This case highlights a multidisciplinary, collaborative approach and a …
Cognitive ERCP: decision making during successful retrieval of proximally migrated biliary stent
Post written by Arjun Chatterjee, MD, from the Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA. A 56-year-old man presented with painless jaundice. A CT scan reported a pancreatic mass, and he underwent ERCP at an outside facility with the placement of a plastic biliary stent through distal biliary stricture and EUS-guided biopsy of …
