By Douglas G. Adler
This quantity offers a entire consultant to complex endoscopic systems and methods. basically excited by Endoscopic Retrograde Cholangiopancreatography (ERCP) and Endoscopic Ultrasound (EUS), the ebook additionally explores comparable themes resembling cholangioscopy, pancreatoscopy, complex pancreaticobiliary imaging, stenting, and endoscopic capability to accomplish ache regulate. The textual content additionally provides a plethora of information and tips on how you can practice those techniques competently, emphasizes universal blunders and the way to prevent them, and contours top of the range video clips illustrating key procedural features for each chapter.
Written through 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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Additional resources for Advanced Pancreaticobiliary Endoscopy
At this point, standard biliary sphincterotomy and stone extraction techniques can be used. EUS-RV can be highly successful based on limited data. , EUS-RV was performed in patients with distal bile duct obstruction in whom selective cannulation of the bile duct at ERCP failed after ﬁve attempts with a guidewire and sphincterotome . The outcomes of EUS-RV were compared with those in a historical cohort of patients who underwent precut papillotomy. Treatment success was signiﬁcantly higher for the EUS-guided RV (57 out of 58 patients) than for those undergoing precut papillotomy (130 out of 144 patients).
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 . The overall stone clearance rate was 88 % with only 7 % of the patients requiring ML. 16 % of patients experienced complications [10, 60]. Complications included pancreatitis, cholangitis, and bleeding without the need for surgery .
The procedure ﬁrst requires a preliminary endoscopic retrograde cholangiogram conﬁrming the presence of a dilated bile duct and large biliary stones [60–63]. A biliary sphincterotomy is performed over the guidewire toward the 1 o’clock position; some proponents of EPBD perform on a limited sphincterotomy while others perform a complete sphincterotomy before dilation [61–63]. Next, an exchange is performed and a large controlled radial expansion (CRE) dilation balloon is advanced over the guidewire.
Advanced Pancreaticobiliary Endoscopy by Douglas G. Adler