ERCP ; Suppurative cholangitis, reuse cannulation catheter better than reuse sphincterotome. скачать в хорошем качестве

ERCP ; Suppurative cholangitis, reuse cannulation catheter better than reuse sphincterotome.

47 Yo male presented with acute fever with chill and epigastric pain 3 days ago, after admission LFT and CT examination reveal multiple gall stones without evidence of cholecystitis, CBD dilatation 9mm with stone size 8mm. ERCP was done the day after CT examination found numerous pus from bile duct and small black stone fragment seen during EST/balloon swept, compatible with recently passing CBD stone. Difficult cannulation from old/reuse sphincterotome due to distortion of catheter tip from cutting wire rotation made inability for cannulation into deep bile duct, after change to simple standard cannulation catheter(the same reuse as well), deep bile duct cannulation easily achieved due to more straight tip than sphincterotome.