ASGE Endoscopy Live: Endoscopic Retrograde Cholangiopancreatography (ERCP) | November 2023-Center for Interventional Endoscopy (Case 2)

Video Transcription

Video Summary

In this video, Dr. Mustafa Aray demonstrates a pancreatoscopy procedure for pancreatic duct stones. The patient is a 62-year-old male who presented with acute pancreatitis three months ago. A CT scan showed a 7mm stone in the pancreatic duct, but the patient decided against intervention. However, he returned a month later with more symptoms and now requires treatment. Dr. Aray explains the importance of conducting an endoscopic ultrasound (EUS) prior to the procedure to assess the downstream duct and ensure there are no strictures or masses. He also discusses the use of different techniques for stone removal, including electrohydraulic lithotripsy (EHL), laser, and saline washing and lavage (SWAL). Dr. Aray encounters difficulty in cannulating the minor papilla due to its small size and distance. He attempts to advance an 018 wire without success and considers switching to a larger wire or performing a sphincterotomy. The video ends with Dr. Aray discussing the challenges of the procedure with other doctors and considering next steps.

Asset Subtitle

Pancreatoscopy PD stone
Mustafa Arain, MD

Keywords

pancreatoscopy procedure

pancreatic duct stones

endoscopic ultrasound (EUS)

stone removal techniques

cannulation difficulty

018 wire

procedure challenges