ASGE Endoscopy Live: Pancreatobiliary Cases and Updates (virtual)

Video Transcription

Video Summary

In this video, Dr. Shayan Nirani shares two cases related to accessing the pancreatic duct and treating benign gastric outlet obstruction after a Whipple procedure. The first case involves a patient with a closed minor sphincter. A guide wire was used to create an anastomosis, but it failed to pass through completely, so a needle knife was used to create a passage, and the sphincterotomy was completed. In the second case, a patient had a necrotic breakdown of the anastomosis after a Whipple procedure. A feeding jejunostomy tube was placed, but the patient developed a stricture. The stricture was dilated and two stents were placed, one for biliary drainage and one for feeding into the efferent limb. The stents were secured to the gastric wall and to each other to prevent migration. Dr. Nirani discusses alternative approaches and addresses questions from other experts. The video was from about 10 years ago, so newer techniques were not available at the time. Overall, these cases demonstrate different strategies for managing complex pancreatic and gastric complications after the Whipple procedure.

Asset Subtitle

Shayan Irani, MD

Keywords

pancreatic duct

benign gastric outlet obstruction

Whipple procedure

sphincterotomy

stents