White (or rather clear) bile related to papillary stone impaction

Abstract

▶ Fig. 1 Endoscopy images. a Duodenoscopy illustrated papillary stone impaction with marked edema. b Primary needle-knife excision of the stone without prior biliary cannulation. c Abundant drainage of translucent, clear bile fluid following stone passage. E-Videos E160Zimmer Vincent. White (or rather clear) bile related to papillary stone impaction … Endoscopy 2020; 52: E160-E161

Acute papillary stone impaction: An ideal indication for upfront needle knife papillotomy (“needle knife excision”)

“…Needle knife papillotomy (NKP) as a freehand, operator‐dependent access technique is traditionally considered a high‐risk procedure in more conventional endoscopic retrograde cholangiopancreatography (ERCP) indications, albeit data are accumulating to suggest a lower risk profile if used early during ERCP procedures 1 . By contrast, papillary stone impaction and the far rarer choledochoceles may represent excellent first‐line indications for upfront NKP, alternatively designated “ needle knife excision ” in the former instance 2 . This is illustrated herein in 39‐year‐old patient with acute biliary‐type pain, marked cholestasis, and minor systemic inflammatory parameters (Figure 1, ).…”