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

Video Transcription

Video Summary

In this video, Dr. Raj Shah from the University of Colorado performs a cholangioscopy to remove a large stone from the bile duct. The stone was not successfully removed in a previous ERCP procedure using conventional methods. Dr. Shah uses a laser fiber to break up the stone, which is located near the duodenoscope. He notes the difficulty of his position due to the patient's anatomy and a peri-ampullary diverticulum. Throughout the procedure, Dr. Shah discusses various techniques and considerations, such as the use of laser versus electrohydraulic lithotripsy, the positioning of the laser fiber, and the risk of mucosal injury. He also mentions the potential need for multiple procedures to fully clear the stone and sets realistic expectations for the patient. Dr. Shah demonstrates the use of a compliant balloon to retrieve stone fragments and provides tips for successful retrieval. The video concludes with final fluoroscopy images showing the successful removal of the stone. No specific credits are mentioned in the transcript.

Asset Subtitle

Raj Shah, MD

Keywords

cholangioscopy

stone removal

bile duct

laser fiber

ERCP procedure

duodenoscope

peri-ampullary diverticulum