Download Advanced Pancreaticobiliary Endoscopy by Douglas G. Adler PDF

By Douglas G. Adler

This quantity presents a entire advisor to complex endoscopic techniques and strategies. basically thinking about Endoscopic Retrograde Cholangiopancreatography (ERCP) and Endoscopic Ultrasound (EUS), the e-book additionally explores similar issues similar to cholangioscopy, pancreatoscopy, complicated pancreaticobiliary imaging, stenting, and endoscopic potential to accomplish ache keep an eye on. The textual content additionally provides a plethora of information and tips on the best way to practice those techniques appropriately, emphasizes universal error and the way to prevent them, and lines top of the range movies illustrating key procedural features for each chapter.
Written by means of best specialists within the box, Advanced Pancreaticobiliary Endoscopy is a useful source for gastrointestinal endoscopists and fellows drawn to complex endoscopic strategies.

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Extra resources for Advanced Pancreaticobiliary Endoscopy

Example text

Surgical removal of large stones by open common bile duct exploration is rarely required. In general, identification of patients with large and difficult stones prior to attempting stone extraction is helpful in achieving higher success rate and minimizing unnecessary complications. When treating patients with large common bile duct stones, we adhere to several core principles: 1. G. 1007/978-3-319-26854-5_2 15 16 T. Queen and G. Parasher Fig. 1 Representative difficult common bile duct stone. (a) Cholangiogram showing a large, tightly impacted stone in the midcommon bile duct.

Saline also provides a medium for shock wave energy transmission [13]. If the bipolar probe is deployed near the duct wall or away from stone, the hydraulic shock waves could cause inadvertent injury or perforation of the bile duct [5, 11]. In addition, contact between the probe and the bile duct walls can potentially result in a delayed biliary stricture. In practice, EHL often involves the probe touching the bile duct walls at least transiently during operation, and in most cases this does not result in any appreciable bile duct injury.

The first study of this technique was reported by Ersoz et al. in 2003 and used large diameter balloons (12–20 mm) after endoscopic sphincterotomy in 58 patients in whom standard endoscopic sphincterotomy and extraction techniques had failed. Forty of the patients had square, barrel shaped and/or large stones (>15 mm) and 18 of the patients had associated biliary strictures [60]. The overall stone clearance rate was 88 % with only 7 % of the patients requiring ML. 16 % of patients experienced complications [10, 60].

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