Advanced Endoscopy Fellows Program | September 2022-Faulx_Biliary CASE_Asge AEF 2022.pdfFaulx

Faulx_Biliary CASE_Asge AEF 2022.pdfFaulx_Biliary CASE

Pdf Summary

The Advanced Endoscopy Course, led by Ashley L. Faulx MD FASGE, is scheduled to take place on September 16-17, 2022. The presenter declares no financial conflict of interest in relation to the content provided or referenced in the course.<br /><br />The case presented during the course involves an 82-year-old patient admitted with jaundice, intermittent pain in the right upper quadrant of the abdomen, a dilated common bile duct (CBD), and gallstones observed in the gallbladder. The question posed is what to do next after performing an endoscopic retrograde cholangiopancreatography (ERCP) procedure.<br /><br />One possible option is to size the cut made during the procedure according to the size of the stone. This can be achieved using a single assembly device with a special crushing basket that is passed through the scope, known as mechanical lithotripsy.<br /><br />Another option is to perform a small endoscopic sphincterotomy (EST) followed by endoscopic papillary large balloon dilation (EPLBD). This approach was discussed by Ding et al in a study that described a stone extraction tunnel consisting of two segments, which takes into account the anatomy of the Oddi sphincter.<br /><br />Additionally, electrohydraulic lithotripsy (EHL) via cholangioscopy can be considered as a treatment option.<br /><br />In summary, the Advanced Endoscopy Course covers various treatment options for managing a case involving an 82-year-old patient with jaundice, RUQ intermittent pain, a dilated CBD, and gallstones seen in the gallbladder. These options include mechanical lithotripsy, small EST followed by EPLBD, and EHL via cholangioscopy.

Keywords

Advanced Endoscopy Course

Ashley L. Faulx

September 16-17, 2022

jaundice

dilated CBD

gallstones

ERCP procedure

mechanical lithotripsy

EST

EPLBD