Endoscopic biliary drainage has become established as first-line treatment for obstructive jaundice. However, if the stent becomes obstructed by tumor ingrowth, re-intervention can sometimes be challenging. One of the challenges can be difficulty in dilating the stricture. Several techniques for resolving this have been reported, such as those using the Soehendra stent retriever or a needle-kni...

Endoscopic management of malignant biliary stricture after hepaticojejunostomy is challenging. Although balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (ERCP) has been developed, dedicated devices are still insufficient. We present a case of successful enteroscopic dilation using a wire-guided diathermic dilator [1–5], and placement of a novel, ultra-slim, uncovered,...

This report describes antegrade electronic hydraulic lithotripsy (Lithotron EL 27; Walz Elektronik, Rohrdorf, Germany) using a digital peroral cholangioscope (SpyGlass DS System; Boston Scientific, Marlborough, Massachusetts, USA) [1, 2] through an endoscopic ultrasound (EUS)-guided hepaticojejunostomy route for common bile duct (CBD) stones (▶Video1). A 77-year-old man, who underwent total gas...

We evaluated the contribution of changes in systemic arterial pressure and local vasodilation to blood flow restoration in contracting human muscles during acute hypoperfusion. Healthy subjects (n=10) performed rhythmic forearm exercise (10% and 20% of maximum) while a balloon in the brachial artery located above the elbow was inflated. Each trial included 3 min of rest, exercise, exercise with...

technique of endoscopic ultrasound (EUS)-guided pseudocyst drainage as a one-step procedure using a novel multiple wire insertion technique facilitated by the double-lumen biliary cytology brush catheter (Cook Medical, Winston-Salem, North Carolina, USA). Six symptomatic patients underwent EUS-guided pseudocyst drainage using the novel multiple wire insertion technique (●" Video 1). After ensur...

Reflex vascular responses to acute left ventricular outflow obstruction were studied in anesthetized dogs. The studies were done to compare the effects of activation of ventricular baroreceptors on vascular resistance in skeletal muscle (gracilis muscle) and skin (hindpaw); to identify afferent and efferent pathways which mediate the reflex vasodilatation; and to assess the relative contributio...

Common bile duct (CBD) stones extraction is usually performed by endoscopic sphincterotomy followed by removal by either a Dormia basket or extraction balloon catheter. However, some stones due to their size are not amenable to these procedures and extracorporeal or mechanical lithotripsy devices need to be used. Mechanical lithotripsy involves usage of a basket that will be inevitably destroye...

AIM To evaluate the safety and efficacy of upper esophageal sphincter (UES) dilatation for cricopharyngeal (CP) dysfunction. To determine if: (1) indication for dilatation; or (2) technique of dilatation correlated with symptom improvement. METHODS All balloon dilatations performed at our institution from over a 3-year period were retrospectively analyzed for demographics, indication and dila...

Mild-to-moderate subglottic and tracheal stenosis can be effectively treated endoscopically, but safe airway management is a key concern. Options have included tracheotomy, jet ventilation, and intermittent apnea technique, each of which has limitations. This article presents the authors’ endoscopic surgical technique using laryngeal mask anesthesia during CO2 laser treatment of subglottic and ...