ERCP Bootcamp for the Endoscopy Team (On-demand) | December 2023-Management of difficult and complex biliary stones

Video Transcription

Video Summary

In this video, Dr. Jason Rogart discusses the management of difficult and complex biliary stones. He begins by discussing the properties that make a stone difficult, such as size, shape, number, location, and altered anatomy. Dr. Rogart then goes on to explain his approach to managing challenging stones, which includes gathering as much information as possible before the procedure, performing a thorough sphincterotomy, utilizing balloon dilation, and using mechanical lithotripsy or cholangioscopy if necessary. He also discusses the use of stents and the importance of post-ERCP pancreatitis prophylaxis. Dr. Rogart offers his own algorithm for managing difficult stones, and provides additional tips for successful stone extraction. He emphasizes the importance of knowing your limits and taking care of the whole patient. Finally, he encourages surgeons to proceed with cholecystectomy soon after stone extraction.

Asset Subtitle

Jason N. Rogart, MD, FASGE

Meta Tag

Concept Choledochal Lithiasis

Concept Pre-ERCP Evaluation

Concept Endoscopic Retrograde Cholangiopancreatography

Concept Gallstone Size

Concept Stone Location

Keywords

difficult biliary stones

stone management

properties of difficult stones

approach to managing challenging stones

ERCP pancreatitis prophylaxis

cholecystectomy after stone extraction

Choledochal Lithiasis

Pre-ERCP Evaluation

Endoscopic Retrograde Cholangiopancreatography

Gallstone Size

Stone Location