Sa1418 ACUTE DISTAL COMMON BILE DUCT ANGLE IS A RISK FACTOR OF POST-ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY PANCREATITIS IN BEGINNER ENDOSCOPIST

2019 ◽  
Vol 89 (6) ◽  
pp. AB221-AB222
Author(s):  
Sungyong Han ◽  
Dong Uk Kim ◽  
Eun Young Park ◽  
Dong Hoon Baek ◽  
Bong Eun Lee ◽  
...  
2017 ◽  
Vol 11 (2) ◽  
pp. 428-433 ◽  
Author(s):  
Hrudya Abraham ◽  
Sajan Thomas ◽  
Amit Srivastava

Biliary sump syndrome is a rare condition. It is seen as a rare long-term complication in patients with a history of a side-to-side choledochoduodenostomy. In the era before endoscopic retrograde cholangiopancreatography, side-to-side choledochoduodenostomy was a common surgical procedure for the management of biliary obstruction. In the setting of a side-to-side choledochoduodenostomy, the bile does not drain through the distal common bile duct anymore. Therefore, the part of the common bile duct distal from the choledochoduodenostomy anastomosis consequently transforms into a poorly drained reservoir, making this so-called “sump” prone to accumulation of debris. These patients are prone to cholangitis. We present a 64-year-old man with a history of side-to-side choledochoduodenostomy who presented with manifestations of cholangitis. An endoscopic retrograde cholangiopancreatography confirmed a diagnosis of sump syndrome. The etiology, clinical manifestations, and treatment of biliary sump syndrome are discussed in this article.


Author(s):  
Thirugnanasambandam Nelson ◽  
AmudaRavichandar Pranavi ◽  
Sathasivam Sureshkumar ◽  
GubbiShamanna Sreenath ◽  
Ananthakrishnan Ramesh ◽  
...  

Long standing biliary stent for biliary stricture may have complications like cholangitis, cholecystitis, stent fracture and stent migration. Treatment includes re-do endoscopic retrograde cholangiopancreatography, removal of fractured stent and restenting. Authors report a case of fractured biliary stent mimicking as distal common bile duct stone. Patient presented with features of cholangitis with history of endoscopic stenting 6 years back but lost follow up thereafter. Ultrasound showed 2cm calculus in distal common bile duct and the stent was seen on endoscopy through the papilla in the duodenum. Contrast enhanced computed tomography of abdomen showed radio opaque dense shadow in the distal common bile duct suggesting possibility of broken biliary stent. Redo endoscopic retrograde cholangiopancreatography failed to remove the fractured stent. A new stent was placed without complications. Patient underwent open common bile duct exploration and the fractured stent was removed. Patient recovered completely after the procedure.


2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Shafqat Mehmood ◽  
Faisal Zeb

Biliary stenting has been used since the 1970s to relieve biliary obstruction for a variety of causes including benign and malignant biliary strictures. Migration of stents proximally into the biliary tree or distally into the intestinal tract is relatively uncommon. We report a case of a 64-year-old female with a peri-ampullary tumour, who had symptomatic obstructive jaundice following endoscopic retrograde cholangiopancreatography and plastic stent insertion. Follow-up imaging showed proximal migration of the plastic stent and blockage of the distal common bile duct (CBD) secondary to the periampullary tumour. The biliary stent was safely removed endoscopically using balloon trawl. This case highlights that, while biliary stenting for strictures is generally safe and effective, stent migration to proximal CBD can occur. Balloon trawl is safe and effective way of removing such stents. Key words: Biliary stricture, common bile duct, endoscopic retrograde cholangiopancreatography, periampullary tumour, stents 


2011 ◽  
Vol 35 (4) ◽  
pp. 279-283 ◽  
Author(s):  
Justin H. Tan ◽  
Fergus V. Coakley ◽  
Zhen J. Wang ◽  
Liina Poder ◽  
Emily Webb ◽  
...  

1994 ◽  
Vol 8 (1) ◽  
pp. 33-35
Author(s):  
Noel B Hershfield

Endoscopic retrograde cholangiopancreatography (ERCP) is established as the method of choice to investigate the biliary tree when obstruction is suspected. On rare occasions, the papilla cannot be entered because of anatomical or pathological abnormalities. This report describes endoscopic fistulotomy or the suprapapillary punch that has been carried out at the Foothills Hospital in Calgary, Alberta, on 30 of 623 patients referred for ERCP for conditions causing obstruction of the common bile duct or suspected obstruction of the common bile duct. The following communication also describes the method of suprapapillary punch or endoscopic fistulotomy. Results have been excellent with only one complication, a minor attack of pancreatitis after the procedure. In summary, the suprapapillary punch or fistulotomy is a safe and useful method for entering the common bile duct when access by the usual method is impossible.


2017 ◽  
Vol 99 (7) ◽  
pp. e213-e215
Author(s):  
S Anwer ◽  
R Egan ◽  
N Cross ◽  
S Guru Naidu ◽  
K Somasekar

Common bile duct stones in patients with a previous gastrectomy can be a technical challenge because of the altered anatomy. This paper presents the successful management of two such patients using non-traditional techniques as conventional endoscopic retrograde cholangiopancreatography was not possible.


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