ASGE DDW Videos from Around the World | 2023-SLICE AND DICE ENDOSCOPIC MANAGEMENT OF LARGE OBSTRUCTING INTRADUODENAL STONE USING ELECTROSURGICAL KNIFE

SLICE AND DICE ENDOSCOPIC MANAGEMENT OF LARGE OBSTRUCTING INTRADUODENAL STONE USING ELECTROSURGICAL KNIFE

Video Transcription

Video Summary

The video discusses the case of a 77-year-old male with Bouvier-Rey syndrome, a rare complication of cholelithiasis. The patient presented with epigastric pain, nausea, and vomiting. CT imaging revealed a large stone obstructing the duodenum, along with gallstones and inflammation. The video documents the endoscopic management of the impacted stone, which involved various techniques including water jet fragmentation and ultimately the use of a submucosal dissection knife with electrosurgical energy. Stone fragments were removed, and a cholecystoduodenal fistula was identified and managed with a stent. The patient later underwent laparoscopic cholecystectomy and successful fistula closure. The video emphasizes the need for further evaluation and experience before adopting this approach widely.

Asset Subtitle

World Cup
Authors: Jerry Yung-Lun Chin, Vinay Chandrasekhara, Bret T. Petersen, Ryan Law

Keywords

Bouvier-Rey syndrome

cholelithiasis

endoscopic management

duodenal obstruction

laparoscopic cholecystectomy

bouvier