ASGE Endoscopy Live: Endoscopic Retrograde Cholangiopancreatography (ERCP) (On-Demand) | November 2023-University College Hospital United Kingdom

Video Transcription

Video Summary

Dr. George Webster discusses a case of percutaneous cholangioscopy with spyglass. The patient is a man in his 50s who presented with obstructive jaundice. He had a previous Roux-en-Y gastric bypass and a distal bearded stone was found on a MRCP. A percutaneous transhepatic external biliary drain was inserted and the patient was referred for consideration of a percutaneous transhepatic approach. Dr. Webster performs the cholangioscopy using a short 65cm scope. He successfully navigates the bile duct, identifies the stone, and performs electrohydraulic lithotripsy to break it up. He then performs a balloon sphincteroplasty and removes the stone fragments with a balloon extraction device. Dr. Webster discusses the advantages of percutaneous cholangioscopy and the various approaches for managing stones in patients with altered anatomy. He emphasizes the importance of individualized management based on patient characteristics and the availability of expertise and technology.

Asset Subtitle

Percutaneous cholangioscopy with Spyglass
George Webster, MD

Keywords

percutaneous cholangioscopy

obstructive jaundice

Roux-en-Y gastric bypass

distal bearded stone

electrohydraulic lithotripsy

balloon sphincteroplasty