Transcystic RendezVous through cholecystoduodenal fistula to salvage failed ERCP

Abstract Text 89-year-old woman, with a history of EUS-guided cholecystoduodenostomy with LAMS (Axios,BostonSci) and stent removal eight weeks later, was admitted to choledocholithiasis associated with cholangitis. ERCP cannulation failed due to intradiverticular papilla. Progressive dilation of the cholecystoduodenostomy tract using a balloon. Cholecystoscopy with a pediatric gastroscope. 0.035 hydrophilic guidewire and the guiding catheter from OASIS were passed through the cystic duct, bile duct, papilla and duodenum. The gastroscope was withdrawn and, a duodenoscope was inserted. Wideguire capture and classic RV was performed. The choledocholithiasis were extracted with a Fogarty balloon. This technique reduced biliary leak and EUS-puncture-guided bleeding. The presence of torsion or a permeable cystic duct is a limiting factor. The use of a completely hydrophilic guidewire facilitated the technique [1].

Video http://data.process.y-congress.com/ScientificProcess/Data//106/570/1428/1aa08943-3ba6-43a9-b762-f13ca9d7a33e/Uploads/16849_RV_ing%20corregido.mp4

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025

• References

• 1 van der Merwe SW, van Wanrooij RLJ, Bronswijk M, Everett S, Lakhtakia S, Rimbas M. et al. Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Guideline Endoscopy.