Cholangioscopy- Assisted Transpapillary Gallbladder Drainage: An Alternative to Endoscopic Ultrasound-Guided Drainage

An ASA IV, 85-year-old man underwent ERCP for acute calculous cholecystitis and sepsis. A dilated CBD=10mm, lithiasis and biliary sludge were found. Sphincterotomy and biliary tract cleaning with balloon catheter were performed. The balloon-occluded-cholangiography showed a high cystic-duct (CD) insertion with a weak gallbladder image. Despite multiple attempts, CD was not cannulated.

A single-operator-digital-cholangioscopy (SpyGlass DS-II) allowed the CD location and guidewire insertion with simultaneous outflow of the small lithiasis that obstructed it. Finally, a 10cmx7Fr double pig-tail plastic stent was placed from gallbladder to duodenum. The stent was removed at 3 months after, when clinical improvement allowed laparoscopic cholecystectomy.

Citation Pijoan Comas E, Torres Monclús N, Alburquerque M et al. eP359V CHOLANGIOSCOPY- ASSISTED TRANSPAPILLARY GALLBLADDER DRAINAGE: AN ALTERNATIVE TO ENDOSCOPIC ULTRASOUND-GUIDED DRAINAGE. Endoscopy 2021; 53: S213.

Publication History

Article published online:
19 March 2021