Successful removal of multiple bile duct stones using a papillary large balloon dilation in a very elderly woman with situs inversus totalis

Shimoda, Fumiko; Satoh, Akihiko; Asonuma, Sho; Umemura, Ken; Shimosegawa, Tooru

doi:10.1007/s12328-020-01198-1

Cited by 5 publications

(4 citation statements)

References 18 publications

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“…However, the ease of insertion may come with difficulty cannulating the papilla, which usually sits in the 1 to 3 o'clock position. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Another technique involved changing the patient position during the procedure, which brought challenges to the endoscopy and was limited by patient intolerance. 20,21 There are few reports in the literature of successful EUS in patients with SIT.…”

Section: Discussionmentioning

confidence: 99%

“…Changed position of room equipment. 180-degree clockwise turn 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 Prone, left lateral Right 180-degree clockwise rotation in stomach or duodenum. Alternatively, “pursuing endoscopy in direction inverse to usual.” Difficulty cannulating and performing papillotomy of 1-3 o’clock papilla needing advanced papillotomy techniques.…”

Section: Discussionmentioning

confidence: 99%

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ERCP and EUS technique in situs inversus totalis: preparing for a left-sided plot twist

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

ERCP and EUS technique in situs inversus totalis: preparing for a left-sided plot twist

et al. 2022

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“…Cannulation in SIT patient is considered difficult due to several aspects: 1.The direction of biliary orifice is inversed to 1–3 o’clock (Fig. 2 d, e), thus selective biliary cannulation maneuvers should be performed inversely as per normal procedures [ 19 , 20 ]. Inadvertent pancreatic duct (PD) cannulation might increase.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of ERCP in patients with situs inversus totalis: multicenter case series and literature review

Ding

Wang

et al. 2022

BMC Gastroenterol

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Background Endoscopic retrograde cholangiopancreatography (ERCP) in patients with situs inversus totalis (SIT) is rarely understood due to its rarity. Patient position and endoscope manipulation were the main concerns in published case reports. The aim of this study was to investigate the efficacy and safety of ERCP in SIT patients. Methods Patients with SIT who underwent ERCP were enrolled in nine endoscopic centers in China. ERCP procedural details and complications in SIT patients were retrieved from electronic medical record. The data was retrospectively analyzed. Results From 2011 to 2021, totally 14 patients with SIT undergoing ERCP were identified. The mean age was 56.8 years old and the male–female ratio was 5:2. The main indication for ERCP was common bile duct stones (13/14, 92.9%). All procedure were performed by experienced endoscopists. 21.4% (3/14) of patients were under regular position (prone), while 78.6% under modified position (supine, left or right lateral). Difficult cannulation was occurred in 71.4% (10/14) of patients. The rate of successful cannulation was 85.7% (12/14). Complication occurred in 3 patients (3/14, 21.4%), including 1 bleeding, 1 pneumonia and 1 acute myocardial infarction. No post-pancreatitis or death happened. Compared to patients in modified position, those in prone position had numerically less successful cannulations (66.7% vs. 90.9%) and higher adverse events (33.3% vs. 18.2%). Conclusions ERCP in patient with SIT is challenging even for experienced endoscopists, modified patient positions might have potential benefits concerning more successful cannulations and less complications. More case experiences are need for comprehensive understanding of ERCP in patients with SIT.

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“…ERCP is one of the most challenging procedures in SI patients. Given the reversed anatomy, a 180-degree clockwise rotation in the duodenum is often required[ 43 - 47 ]. Furthermore, cannulation to the bile duct is difficult because of the lack of visualization and the ectopic location of the ampulla of Vater in SI patients[ 7 ].…”

Section: Acute Biliary Tract Disease In Situs Inversus Patientsmentioning

confidence: 99%

Laparoscopic common bile duct exploration to treat choledocholithiasis in situs inversus patients: A technical review

Chiu¹,

Chuang²,

Chuang³

et al. 2023

World J Clin Cases

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Situs inversus (SI) is a rare congenital condition characterized by a mirror-image transposition of the major visceral organs. Since the 1990s, more than one hundred SI patients have been reported to have successfully undergone laparoscopic cholecystectomy. In these cases, the major problem is to overcome is the left-right condition for right-handed surgeons. Laparoscopic common bile duct exploration (LCBDE), an alternative to treat patients with bile duct stones, has shown equivalent efficacy and is less likely to cause pancreatitis than endoscopic retrograde cholangiopancreatography. Recent updated meta-analyses revealed that a shorter postoperative hospital stay, fewer procedural interventions, cost-effectiveness, a higher stone clearance rate, and fewer perioperative complications are additional advantages of LCBDE. However, the technique is technically demanding, even for skilled laparoscopic surgeons. Conducting LCBDE in patients with difficult situations, such as SI, is more complex than usual. We herein review published SI patients with choledocholithiasis treated by LCBDE, including our own experience, and this paper focuses on the technical aspects.

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Successful removal of multiple bile duct stones using a papillary large balloon dilation in a very elderly woman with situs inversus totalis

Cited by 5 publications

References 18 publications

ERCP and EUS technique in situs inversus totalis: preparing for a left-sided plot twist

ERCP and EUS technique in situs inversus totalis: preparing for a left-sided plot twist

Efficacy and safety of ERCP in patients with situs inversus totalis: multicenter case series and literature review

Laparoscopic common bile duct exploration to treat choledocholithiasis in situs inversus patients: A technical review

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