Use of digital cholangioscopy in a dilated bile duct for detection of small symptomatic bile duct stones

A 47-year-old woman recently underwent an ERCP with mechanical lithotripsy for a symptomatic stone. The stone was cleared per the endoscopist, but because of ampullary edema a stent was placed. The patient continued to experience right upper-quadrant abdominal pain, and thus the clinical picture suggested a retained stone. A subsequent ERCP was performed for stent removal and re-evaluation. The stent was removed, and multiple balloon sweeps that started at the hilum yielded no stones. An occlusion cholangiogram showed a bile duct dilated to 15  mm and no filling defects (Fig. 1A).

Source: Gastrointestinal Endoscopy - March 13, 2016 Category: Gastroenterology Authors: Arvind J. Trindade, Robert Hirten, Divyesh V. Sejpal Tags: VideoGIE Source Type: research