Commentary

This novel technique demonstrates that endoscopic retrograde cholangiopancreatography (ERCP)-type procedures can be safely performed without fluoroscopy by using the duodenoscope in combination with transabdominal ultrasound. Nowadays, ERCP is the first-line therapy for decompression of the bile ducts in patients with suppurative cholangitis, a life-threatening condition. Apart from endoscopy for gastrointestinal tract diseases, ERCP requires fluoroscopy as well as the duodenoscope to obtain cholangiopancreatography. Thus, if the fluoroscopy system is unavailable, for example because of breakage, the condition of patients with acute cholangitis needing bile duct drainage, can deteriorate finally becoming lethal. To the best of its authors’ knowledge, this is the first video report of radiation-free direct endoscopic drainage of the common bile duct using transabdominal ultrasound. Mönkemüller et al. are to be congratulated on this distinctive report.

Publication History

Article published online:
23 September 2020