Endoscopy 2025; 57(S 02): S402
DOI: 10.1055/s-0045-1806021
Abstracts | ESGE Days 2025
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Clip-band traction of a post-surgical granuloma to undergo ERCP for difficult choledocolithiasis in a patient with Billroth II gastrectomy

Authors

  • L Dottori

    1   Sapienza University of Rome, Roma, Italy

  • P L Marmo

    1   Sapienza University of Rome, Roma, Italy

  • S Dolci

    1   Sapienza University of Rome, Roma, Italy

  • B Annibale

    2   Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy

  • S Angeletti

    1   Sapienza University of Rome, Roma, Italy
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Abstract Text Endoscopic retrograde cholangiopancreatography (ERCP) in case of Billroth II (BII) gastrectomy is known to be a challenging procedure. We present the case of a 78-year-old man referred to our center for choledocolithiasis. During ERCP we discovered ha had a BII gastrectomy. Thus a pediatric colonoscope was used to reach the papilla, but the BII sphincterotome was unavailable. Once reached the papilla, we found a pseudopolypoid granuloma making the access difficult. With clip-band traction of the granuloma we gained access to papillary orifice and main bile duct (MBD). Cholangioscopy showed a dilated MBD with a stone up to 15 mm inside it. Considering the altered anatomy and the stone size, stone removal attempt was avoided and a plastic stent 7Frx7cm was placed. No complications came up and the patient was then sent to a tertiary centre for stone removal [1] [2].

Video  http://data.process.y-congress.com/ScientificProcess/Data//106/570/1428/e1f9fd5f-d676-4488-980b-28cd76fdc846/Uploads/16849_18-11LDVideo-case-reportESGE25_-%20Realizzato%20con%20Clipchamp.mp4



Publication History

Article published online:
27 March 2025

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