Advanced Endoscopy Fellows Program | September 2022-Management of Adverse Events Case Based Discussion #4

Video Transcription

Video Summary

In this video, the speaker, Roberto, discusses two cases related to biliary strictures and stent migration. In the first case, a patient with indeterminate biliary strictures has a stent placed, but later presents with pain. A CT scan reveals possible stent migration. Roberto emphasizes the importance of remaining calm and assessing the overall picture before proceeding with any intervention. He highlights the need for communication with the medical team and considering the possibility of perforation. Ultimately, the stent is successfully removed using a raptor and an over-the-scope clip is used to close the perforation.<br /><br />In the second case, a patient from an outside hospital has a missing stent. Multiple attempts to retrieve the stent using different tools fail. Ultimately, a SpyBite device is used to successfully remove the stent. Roberto mentions the importance of trying various techniques and using a balloon or wire to aid in retrieval. He also shares a study on delayed adverse events after ERCP, emphasizing the need for follow-up and communication with patients.<br /><br />The video provides insights into the challenges and strategies involved in managing complications related to stent migration and highlights the importance of teamwork, communication, and transparency with patients.

Asset Subtitle

Patrick Pfau, Mo Al-Haddad, Rajesh Keswani, Roberto Simons-Linares

Keywords

biliary strictures

stent migration

perforation

stent retrieval

communication