Percutaneous single-operator video cholangioscopy using a novel short disposable endoscope: first clinical case with treatment of a complex biliary stone and inaccessible papilla after Roux-en-Y reconstructive surgery

نویسندگان

چکیده

ERCP is technically challenging and time consuming in patients with surgically altered upper GI anatomy, particular after Roux-en-Y reconstruction. A conventional endoscopic approach using side-viewing duodenoscopes frequently fails, an enteroscopy-assisted technique has to be performed. However, the efficacy of therapeutic interventions via enteroscopic route usually limited.1Ayoub F. Brar T.S. Banerjee D. et al.Laparoscopy-assisted versus retrograde cholangiopancreatography (ERCP) gastric bypass: a meta-analysis.Endosc Int Open. 2020; 8: E423-E436Crossref PubMed Google Scholar, 2Shah R.J. Smolkin M. Yen R. al.A multicenter, U.S. experience single-balloon, double-balloon, rotational overtube-assisted enteroscopy pancreaticobiliary anatomy (with video).Gastrointest Endosc. 2013; 77: 593-600Abstract Full Text PDF Scopus (186) 3Skinner Popa Neumann H. al.ERCP technique: systematic review.Endoscopy. 2014; 46: 560-572Crossref (155) Scholar Direct cholangioscopy emerged as cornerstone evaluation indeterminate biliary strictures treatment for complex stones.4Bokemeyer A. Gerges C. Lang al.Digital single-operator video treating refractory stones: multicenter observational study.Surg 34: 1914-1922Crossref (18) 5Gerges Beyna T. Tang R.S.Y. peroral cholangioscopy-guided biopsy sampling ERCP-guided brushing strictures: prospective, randomized, trial 91: 1105-1113Abstract (51) 6Tringali Lemmers Meves V. al.Intraductal biliopancreatic imaging: European Society Gastrointestinal Endoscopy (ESGE) technology 2015; 47: 739-753Crossref (71) Currently, no system on market can used approach. Thus, these situations require percutaneous insertion endoscope into bile duct system.7Ahmed S. Schlachter T.R. Hong K. Percutaneous transhepatic cholangioscopy.Tech Vasc Interv Radiol. 18: 201-209Abstract (30) Scholar,8Tsutsumi Kato Yabe comparative methods stones hepaticojejunostomy between peroral, short double-balloon enteroscopy.Therap Adv Gastroenterol. 2017; 10: 54-67Crossref (11) The first step always establish access; this done either by interventional endoscopist or radiologist, depending local expertise policy. second series bougination sessions, until mature stable access achieved. Traditionally, aside from bronchioscopes, dedicated cholangioscopes are used. some critical drawbacks.9Choi J.H. Lee S.K. cholangioscopy: does its role still exist?.Clin 529-536Crossref (19) First, reprocessable endoscopes cannot totally sterilized thus prone risk infection cases unrecognized contamination. Second, minimum diameter around 5 mm, implying long-lasting sequential tract at least 16F within 3 4 sessions. Third, bronchioscopes offer only 2-way deflection, which substantially limits their maneuverability capability performing interventions. Since 2015, digital videocholangioscopy (SOVC) been available transpapillary direct cholangioscopy. Its benefits intraluminal therapy difficult-to-treat pancreatic have studied clinical trials.5Gerges Scholar,10Navaneethan U. Hasan M.K. Kommaraju al.Digital, cholangiopancreatoscopy diagnosis management pancreatobiliary disorders: 2016; 84: 649-655Abstract Scholar,11Gerges Pullmann Bahin al.SpyGlass DS-guided lithotripsy symptomatic treatment-refractory chronic calcifying pancreatitis.Endosc 2019; 7: E99-E103Crossref Case reports shown that device also tool access, although it was formally built long over accessory channel standard duodenoscope.12Peck J.R. Spain J. Al Taani al.Percutaneous antegrade disorders.VideoGIE. 2: 145-146Abstract (3) 13Trikudanathan G. Singh Shrestha P. intraductal electrohydraulic choledocholithiasis inaccessible papilla.VideoGIE. 152-154Abstract 14Hubers Patel Dalvie patient complicating benign stricture.VideoGIE. 4: 423-425Abstract 15Fujii Y. Koshita Ito SpyGlassDS anastomotic stenosis choledochojejunostomy.Dig 2018; 30: 806-807Crossref (4) offers advantages reusable endoscopes. SOVC itself 10.5F, reducing target 11F. manufactured delivered sterile package, minimizes endoscope-transmitted infections. 4-way deflection capabilities allow excellent system. limitation is, course, smaller 1.2 mm diameter. forceps 1.9F probe available. Finally, length original use daily practice. We report here case novel system, specifically designed access. Not maintain all aforementioned advantages, but catheter (65 cm) further improves endoscope’s tip improved handling owing shorter (Fig. 1). 63-year-old man referred another institution obstructive jaundice severe cholangitis complicated cholangiosepsis. MRCP revealed large, obstructing stone common duodenum-preserving head resection pancreatitis 2 years earlier.16Frey C.F. Amikura Local pancreas combined longitudinal pancreaticojejunostomy pancreatitis.Ann Surg. 1994; 220 (discussion 7): 492-504Crossref (259) underwent curative right hemicolectomy colonic cancer 1 year later. He had recovery, resulting multiple adhesions need emergency surgery acute small-bowel obstruction months before presentation. This may why previous device-assisted failed. drainage our institution, leading quick stabilization. Two sessions wire-guided sinus were needed achieve soft Yamakawa implanted temporary internal drainage. interval weeks maturation fistula, performed 2), successful fragmentation under vision. Most fragments pushed duodenum continuous irrigation 3; Video 1, online www.VideoGIE.org). small remaining percutaneously extracted vision dormia extraction basket. After documentation complete clearance, implantation needed.Figure 3A, Cholangioscopic visualization large proximal working channel. B, Effective achieved.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Novel promises useful addendum armamentarium options selected hepatobiliary diseases

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Successful biliary drainage with peroral direct cholangioscopy in a patient with Roux-en-Y hepaticojejunostomy for congenital biliary dilatation.

The diagnostic and therapeutic effectiveness of combined double-balloon endoscopy with a short endoscope and peroral direct cholangioscopy with an ultraslim endoscope in patients who have altered gastrointestinal anatomy has been demonstrated [1–5]. We describe successful biliary drainage with a short double-balloon endoscope and peroral direct cholangioscopy in a patient who had cholangitis af...

متن کامل

Kidney stone risk following Roux-en-Y gastric bypass surgery

Since the first report in 2005, Roux-en-Y gastric bypass (RYGB) surgery has been linked to a variety of metabolic changes that alter kidney stone risk. The studies with the highest level of evidence, performed in non-stone forming patients before and after RYGB, cite a number of kidney stone risk factors, including a 25% increase in urinary oxalate, a 30% decrease in urinary citrate, and reduct...

متن کامل

Comparative Endoscopic Evaluation of Reconstructive Roux-en-Y With Jejunal Loop Interposition Following Gastrectomy in Dogs

Objective-  Comparative endoscopic evaluation of two reconstructive methods (R&Y and jejunal loop interposition) after gastrectomy in dogs. Design- Experimental study. Animals- Ten healthy male dogs. Procedures- The animals were divided randomly in two groups. After a 12 hour food with hold and under general anesthesia laparotomy is performed in all dogs. In group A (R&Y), after dissectio...

متن کامل

Biliary reconstruction and duodenal repair with a single Roux-en-Y jejunal loop

A simple surgical technique, which permits biliary reconstruction and repair of a duodenal injury with a single Roux-en-Y jejunal loop, is described. Its simplicity and effectiveness are encouraging.

متن کامل

Percutaneous gastrostomy of the excluded gastric segment after Roux-en-Y gastric bypass surgery.

A new technique for percutaneous gastrostomy of a decompressed excluded gastric segment after Roux-en-Y gastric bypass (RYGBP) surgery is described and the results in a single institution are reviewed. Computed tomography guidance was used to place a 21- or 22-gauge needle into the lumen of the stomach and distend it to allow placement of a feeding catheter. Ten women underwent the procedure, a...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

ژورنال

عنوان ژورنال: VideoGIE

سال: 2021

ISSN: ['2468-4481']

DOI: https://doi.org/10.1016/j.vgie.2020.08.015