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

Video Transcription

Video Summary

In this video, a case is presented of a 69-year-old female with a history of atrial fibrillation who has a walled-up pancreatic necrosis. She presents with abdominal pain and early satiety. Her liver enzymes are mildly elevated and an MRI shows significantly dilated bile ducts. The patient undergoes an ERCP that is complicated by a duodenal perforation and severe post-ERCP pancreatitis, resulting in a large necrotic collection. The video demonstrates the use of an EUS-guided drainage and necrosectomy using a power-endoscopic debridement device. The device is shown to effectively suction and remove necrotic tissue from the collection. The video concludes with the placement of a double-pigtail stent to prevent leakage and recurrent collections. The presenter emphasizes the importance of proper indication and technique when performing ERCP and advises caution when accessing the collection to avoid damaging the wall or blood vessels. The goal is to leave the stent in place until the collection is resolved and follow up with short-term CAT scans. The video is part of a course organized by the ASGE and is intended to showcase the use of the endorotor device for necrosectomy.

Asset Subtitle

Mouen Khashab, MD

Keywords

pancreatic necrosis

ERCP

necrosectomy

EUS-guided drainage

double-pigtail stent

ASGE