ASGE DDW Videos from Around the World | 2022-LITHOTRIPSY WITH SPYBITE IN HEPATOLITHIASIS DURING PERCUTANEOUS/ENDOSCOPIC RENDEZ-VOUS AND SPYGLASS

LITHOTRIPSY WITH SPYBITE IN HEPATOLITHIASIS DURING PERCUTANEOUS/ENDOSCOPIC RENDEZ-VOUS AND SPYGLASS

Video Transcription

Video Summary

In this video, a 63-year-old male patient with a history of abdominal pain, jaundice, and fever underwent lithotripsy with a spy bite in the patholysis during percutaneous endoscopic rendezvous and spyglass. The patient had comorbidities of systemic arterial hypertension and a past cholecystectomy. The initial diagnostic tests revealed multiple calculi in the common bile duct and intrahepatic segments 3 and 4, leading to a diagnosis of moderate acute cholangitis. Initially, a percutaneous transepatic biliary drainage was performed. After seven days, a rendezvous percutaneous endoscopic ERCP with papillotomy and balloon dilation was carried out to extract the remaining stones. However, a follow-up cholangiography revealed persistent stones. To address this, percutaneous antegrade cholangioscopy was recommended. Using a SpyBite, a biopsy was performed on the common bile duct, and a retrograde cholangioscopy was conducted to access and remove stones in the intrahepatic segment 4. A guide wire was then placed in segment 3 to remove the remaining stones. Subsequent cholangiography showed no remaining stones.

Keywords

abdominal pain

jaundice

fever

lithotripsy

cholangitis