Should ERCP be Conducted in Special Circumstances without Fluoroscopy? Contra

Rp, Venu; Rd, Brown

doi:10.1055/s-2007-1001260

Cited by 1 publication

(2 citation statements)

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“…This method cannot distinguish the cystic duct from the common bile duct, which increases the risk of placing the stent in the cystic duct, with failure of biliary decompression and potential ob− struction or perforation of the cystic duct. The possibility of loop− ing of the guide wire, leading to improper placement of the stent, has also been suggested [12], especially for obstructive lesions of the proximal common bile duct, where a failure rate close to 50 % has been reported [11]. Less commonly, transabdominal ultra− sound has been used for confirmation of biliary cannulation [ 1,3,5].…”

Section: Discussionmentioning

confidence: 99%

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Therapeutic Endoscopic Retrograde Cholangiopancreatography without Fluoroscopy in Four Critically Ill Patients Using Wire-Guided Intraductal Ultrasound

et al. 2005

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Emergent endoscopic retrograde cholangiopancreatography cannot be performed at the bedside in critically ill patients in an intensive care unit because of the requirement for fluoroscopy. Moving such patients to a safe location where fluoroscopy is available can pose practical problems, and can lead to delayed intervention, which may adversely affect the outcome. We report the use of intraductal ultrasound to facilitate therapeutic biliary interventions in four critically ill patients in an intensive care unit. Cannulation was performed endoscopically at the bedside using a sphincterotome and a guide wire. Intraductal ultrasound, rather than fluoroscopy, was then used to confirm the location of the wire within the common bile duct prior to performing endoscopic sphincterotomy or stent placement. This technique was successful in all four patients.

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Section: Discussionmentioning

confidence: 99%

“…Biliary cannulation was confirmed in these cases by bile aspiration [2, 4, 6 ± 8,11] or, less frequently, by transabdominal ultrasound [1,3,5]. Although no complica− tions were reported, some authors have questioned the safety of performing therapeutic ERCP without fluoroscopy [12].…”

Section: Introductionmentioning

confidence: 99%