ASGE Annual Postgraduate Course: Clinical Challenges and Real-Time Decision Making in GI Endoscopy (Live and Virtual)

Video Transcription

Video Summary

In this video, Dr. Raj Shah from the University of Colorado performs cholangioscopy on a patient with a large bile duct stone. The attempt at ERCP was unsuccessful, so Dr. Shah uses a laser fiber to break up the stone. He explains that the laser delivers energy through an aqueous medium to fracture the stone, and he emphasizes the need to avoid mucosal trauma and to keep the laser fiber in the middle of the lumen. Dr. Shah mentions that some patients may require multiple sessions to completely clear the stones, and that adjunctive measures such as large balloon dilation or mechanical lithotripsy may be necessary. He also discusses the importance of setting realistic expectations with the patient and obtaining informed consent. The video concludes with final fluoroscopy images showing successful fragmentation and removal of the stone. No credits were given for the video.

Asset Subtitle

Raj Shah, MD

Keywords

cholangioscopy

bile duct stone

ERCP

laser fiber

mucosal trauma

adjunctive measures

informed consent