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You are here: Home / Abstracts / Endoscopic management of the difficult hepatic biliary duct stone with digital direct cholangiography

Endoscopic management of the difficult hepatic biliary duct stone with digital direct cholangiography

Renzo Pinto, Efrain J Isaacs, Laura Quintero, Luis F Cabrera, General Surgeon, Daniel Gomez, MD, FACS, Mauricio Pedraza, Jean Pulido. Bosque University

Introduction:Digital direct cholangiography or Spyglass (Boston Scientific Corp., Natick, MA, USA) is a modern and simplified technique, which allows a single endoscopist a better visualization of the biliary tract and equipment maneuverability. Using this unique technique, it is possible to fragment and extract bile stones using a mechanical lithotripter or a pulsed dye laser, with a successful rate greater than 90%

Objective: To describe the utility of the direct cholangioscopy and laser lithotripsy in the management of the difficult common bile duct stones, in two patients with biliary stenosis

Materials and methods: 2 patients were treated in the Bogota, Colombia, between the years of 2015 and 2018  in a fourth level hospital, who presented with distal biliary stenosis and choledocolitiasis. This patients also had difficult bile duct stones criteria, which is the reason why direct cholangioscopy and laser lithotripsy was indicated, with 100% success and no complications.

Results: The 2 cases had complete resolution of hepatolithiasis, being able to overcome the distal stenosis and preventing new episodes of cholangitis.

Conclusions: Digital direct cholangiography or Spyglass, is an endoscopic technique which allows direct vision of the biliary tract and the bile ducts. Using this technique, it is possible to fragmentate all the bile stones and overcome bile duct stenosis, prevent cholangitis and spare the patient of a possible hepatectomy


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95521

Program Number: P216

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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