ERCP Bootcamp: Cutting Edge Comprehensive Training for the Team | July 2026-Cased Based Discussions and Closing Remarks

Video Transcription

Video Summary

The final session was an open case discussion focused on challenging ERCP-related scenarios. Experts, led by Dr. Praveen Chahal, fielded questions from attendees.<br /><br />A major case involved a young man with alcohol use disorder, compensated cirrhosis, recurrent pancreatitis, pancreatic duct obstruction, and pancreatic ascites. Despite ERCP with a pancreatic stent bridging a leak, octreotide, NJ feeding, and TPN, the ascites persisted. The panel discussed whether the problem was purely pancreatic or multifactorial, emphasizing nutritional optimization, continued pancreatic rest, and potentially upsizing or adding additional pancreatic stents if anatomy allowed. Because the patient had worsening duodenal obstruction and was not a surgical candidate, options remained limited.<br /><br />Another topic was groove pancreatitis, explained as inflammation in the pancreaticoduodenal groove often seen in smokers/drinkers with chronic pancreatitis. The faculty noted that prolonged conservative therapy can help some patients, but many still require surgery; management is slow and difficult.<br /><br />The group also discussed asymptomatic common bile duct stones and asymptomatic walled-off necrosis. Consensus was generally not to treat imaging alone unless there are symptoms, vascular compromise, or other objective complications.<br /><br />The session ended by emphasizing that ERCP is a complex team sport: success depends on communication, coordination, and knowing the equipment, devices, and roles of everyone in the room.

Keywords

ERCP

pancreatic ascites

groove pancreatitis

common bile duct stones

walled-off necrosis

pancreatic stent

chronic pancreatitis