ASSOCIATED FACTORS WITH ABSCENSE OF BILE DUCT STONE AT ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP) IN PATIENTS WITH CHOLEDOCHOLITHIASIS DOCUMENTED ON MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY (MRCP)

2019 ◽  
Author(s):  
R Palos-Cuellar ◽  
E Murcio-Pérez ◽  
A Ferreira-Hermosillo ◽  
OM Solórzano-Pineda ◽  
G Blanco-Velasco ◽  
...  
Keyword(s):  
Bile Duct ◽  
Magnetic Resonance ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Associated Factors ◽  
Bile Duct Stone ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Endoscopic Retrograde

Analysis of Endoscopic Retrograde Cholangiopancreatography after Positive Intraoperative Cholangiogram: Is it Necessary?

2016 ◽  
Vol 82 (10) ◽  
pp. 985-988
Author(s):  
John V. Gahagan ◽  
Steven Maximus ◽  
Matthew D. Whealon ◽  
Michael J. Phelan ◽  
Aram Demirjian ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Acute Cholecystitis ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Nationwide Inpatient Sample ◽  
Bile Duct Stone ◽  
Stone Extraction ◽  
Endoscopic Retrograde ◽  
Intraoperative Cholangiogram ◽  
Nationwide Inpatient Sample Database

The necessity of routine endoscopic retrograde cholangiopancreatography (ERCP) after positive intraoperative cholangiogram (IOC) during laparoscopic cholecystectomy is not well defined. We aimed to examine the incidence of positive IOC among patients who undergo IOC during cholecystectomy and the rate of subsequent ERCP stone extraction. The Nationwide Inpatient Sample database was reviewed for all patients undergoing cholecystectomy with IOC from 2002 to 2012. Patients were then analyzed for ERCP and stone extraction. A total of 73,508 patients who underwent cholecystectomy with IOC for a diagnosis of acute cholecystitis and found to have a bile duct stone were identified. Of these patients, 5915 underwent subsequent ERCP. In the patients that underwent subsequent ERCP, 1478 had a documented stone extraction during ERCP. The rate of stone extraction in the ERCP subset is 25 per cent, which is 2 per cent of all patients who had a positive IOC. The rate of stone extraction after positive IOC is low. Positive IOC may not warrant a routine postoperative ERCP. Our results suggest that clinical monitoring of patients with positive IOC is reasonable, as the majority of patients with a positive IOC ultimately have no stone extraction.

scholarly journals A Novel Two-Step Approach for Retrieval of an Impacted Biliary Extraction Basket

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Calvin H. Y. Chan ◽  
Fergal Donnellan ◽  
Godfrey C. K. Chan ◽  
Michael F. Byrne
Keyword(s):  
Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Balloon Dilatation ◽  
Bile Duct Stone ◽  
Surgical Removal ◽  
Distal Bile Duct ◽  
Endoscopic Retrograde ◽  
Safe Technique

Biliary extraction baskets are a commonly used instrument for the removal of choledocholithiasis in endoscopic retrograde cholangiopancreatography (ERCP). Impaction of the extraction basket is a recognized complication of ERCP, and is usually the result of discrepancy between the size of bile duct stone and the diameter of the distal bile duct. Whilst mechanical lithotriptors can be used to crush the stone or break the wires of the basket to allow its release, failure of the lithotriptor device can occur. We describe the case of a 59-year-old gentleman who had an ERCP performed for choledocholithiasis. Basket impaction was encountered, and the mechanical lithotriptor failed to dislodge the stone/basket complex. A two-step technique involving balloon dilatation and forceps manipulation of the basket was applied to successfully dislodge the impacted basket. We believe this simple and safe technique should be adopted to rescue impacted biliary extraction baskets to avoid the need for potential surgical removal.

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