Gastroscopy with electrohydraulic lithotripsy (EHL) using mother-baby cholangioscopy
Live endoscopy from the HSK Dr. Horst Schmidt Hospitals in Wiesbaden in collaboration with „Video Journal and Encyclopedia of GI Endoscopy“.
©2013 Elsevier. All rights reserved. Wirth the friendly assistance of Falk Foundation e.V., Freiburg.
Gerhard Mayer and Jürgen Pohl, HSK Dr. Horst-Schmidt-Kliniken Wiesbaden, Germany
This is the case of an 80-year-old woman who presented in the hospital with severe cholestasis. Sonography revealed a marked dilation of the intra- and extrahepatic bile ducts. The ERCP demonstrated a 3 cm gallstone that could not be captured with the basket and undergo mechanical lithotripsy.
For this reason, a second step is performed using a mother-baby cholangioscopy with electrohydraulic lithotripsy under direct visual guidance, which is presented here.
Take home messages:
- The innovative “short access” mother-baby cholangioscopy system with an ultra-short cholangioscope offers many promising mechanical advantages during cholangiopancreatography.
- EHL is a valuable option for intraductal lithotripsy of complex and incarcerated stones. The EHL must be performed by cholangioscopy under direct visual guidance, since the application of energy to the mucosa can damage the bile ducts.
Please don’t forget to switch on your loudspeakers
Link to Falk Mediacenter:
Link to the video directly:
180 x 130 pixels
580 x 350 pixels
Latest research in brief:
Description field (to be displayed at the end of the structural element):
Editor: Prof. W. Kreisel, Medical University Hospital, 79106 Freiburg, Germany
Syed A et al, Am J Gastroenterol. 2013;108(4):583–93
In this study, use of anti-TNF therapy in Crohn’s disease patients = 8 weeks before intestinal resection or any intra-abdominal surgery was independently associated with increases in infectious and surgical complications.
Sakuraba A et al, Inflamm Bowel Dis. 2013;19(3):621–6
A large series of natalizumab-treated patients with Crohn’s disease shows that this anti-integrin-antibody is an efficacious and safe treatment agent for patients refractory to anti-TNF agents.
Kassam Z et al, Am J Gastroenterol. 2013;108(4):500–8
A meta-analyis: Fecal microbiota transplantation holds considerable promise as a therapy for recurrent Clostridium difficile infection but well-designed, randomized-controlled trials and long-term follow-up registries are still required.
Carbone M et al, Gastroenterology. 2013;144(3):560–9
Among patients with primary biliary cirrhosis, response to ursodeoxycholic acid treatment and symptoms are related to sex and age at presentation, with the lowest response rates and highest levels of symptoms in women presenting at younger than age 50.
Lawitz E et al, N Engl J Med. 2013;368(20):1878–87
In a single-group study of the new nucleotide-polymerase inhibitor sofosbuvir combined with peginterferon-ribavirin, patients with predominantly genotype 1 or 4 hepatitis C virus infection had a rate of sustained virologic response of 90% at 12 weeks.
Mohd Hanafiah K et al, Hepatology. 2013;57(4):1333–42
Increasing prevalence of hepatitis C virus infection: Prevalence 2.8% world-wide.
Rubenstein JH et al, Am J Gastroenterol. 2013;108(3):353–62
A model based on GERD, age, abdominal obesity, and cigarette use more accurately classifies the presence of Barrett’s esophagus than does a model based on GERD alone.
Georgopoulos S et al, J Clin Gastroenterol. 2013;47(3):228–32
A 10-day concomitant quadruple therapy of H. pylori achieves high eradication rates.
Lee YC et al, Gut. 2013;62(5):676–82
Population-based eradication of Helicobacter pylori infection in Taiwan has led to a significant reduction in gastric atrophy (the precursor lesion of gastric carcinoma) and in peptic ulcer disease, at the expense of increased esophagitis.
Shiokawa M et al, Am J Gastroenterol. 2013;108(4):610–7
Patients with autoimmune pancreatitis (AIP) are at high risk of having various cancers. The highest risk for cancer in the first year after AIP diagnosis and absence of AIP relapse after successful treatment of the coexisting cancers suggest that AIP may develop as a paraneoplastic syndrome in some patients.
November 22 – 23, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
January 23 – 24, Universitätsklinikum Tübingen, CRONA Kliniken, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
Current Falk literature:
Mucosal healing in inflammatory bowel disease
Influence of the different mechanisms of action of mesalazine on mucosal healing in ulcerative colitis
Scientific editor: W. Kruis
Revised edition 2013