ASGE Endoscopy Live: Pancreatobiliary Cases and Updates (On-Demand)

Video Transcription

Video Summary

In this video, doctors discuss the case of an 88-year-old female with a possible biliary obstruction. The patient has a history of rheumatoid arthritis and prior cholecystectomy. She presents with postprandial abdominal pain, elevated liver enzymes, and a dilated intra and extrahepatic bile duct, as seen in MRI and MRCP images. ERCP is attempted but unsuccessful due to the location of the papilla within a large perianal diverticulum. The patient also reports symptoms of intermittent postprandial nausea, vomiting, abdominal distention, and weight loss. The doctors discuss possible causes and differential diagnoses, including cortical cysts, SMA syndrome, and sphincter of Oddi dysfunction. They decide to perform EUS guided interventions and ERCP to evaluate the small intestine and biliary system. The video shows the EUS procedure and demonstrates the placement of a fully covered hybrid gastrostomy stent to provide drainage and relieve symptoms. Further follow-up will be needed to evaluate the effectiveness of the treatment. The doctors highlight important technical aspects and considerations throughout the procedure.

Asset Subtitle

Mouen Khashab, MD

Keywords

biliary obstruction

cholecystectomy

ERCP

EUS procedure

gastrostomy stent

follow-up