Treatment Using the SpyGlass Digital System in a Patient with Hepatolithiasis after a Whipple Procedure

Treatment Using the SpyGlass Digital System in a Patient with Hepatolithiasis after a Whipple Procedure

An 89-year-old man was referred to our hospital for treatment of hepatolithiasis causing recurrent cholangitis. He had undergone a prior Whipple procedure. Computed tomography demonstrated left-sided hepatolithiasis. First, we conducted peroral direct cholangioscopy (PDCS) using an ultraslim endosco...

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Veröffentlicht in:Clinical endoscopy 2018-11, Vol.51 (6), p.596
Hauptverfasser: Hirofumi Harima, Kouichi Hamabe, Fusako Hisano, Yuko Matsuzaki, Tadahiko Itoh, Kazutoshi Sanuki, Isao Sakaida
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Cholangioscopy
Hepatolithiasis
SpyGlass digital system
Whipple procedure
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container_issue 6
container_start_page 596
container_title Clinical endoscopy
container_volume 51
creator Hirofumi Harima
Kouichi Hamabe
Fusako Hisano
Yuko Matsuzaki
Tadahiko Itoh
Kazutoshi Sanuki
Isao Sakaida
description An 89-year-old man was referred to our hospital for treatment of hepatolithiasis causing recurrent cholangitis. He had undergone a prior Whipple procedure. Computed tomography demonstrated left-sided hepatolithiasis. First, we conducted peroral direct cholangioscopy (PDCS) using an ultraslim endoscope. Although PDCS was successfully conducted, it was unsuccessful in removing all the stones. The stones located in the B2 segment were difficult to remove because the endoscope could not be inserted deeply into this segment due to the small size of the intrahepatic bile duct. Next, we substituted the endoscope with an upper gastrointestinal endoscope. After positioning the endoscope, the SpyGlass digital system (SPY-DS) was successfully inserted deep into the B2 segment. Upon visualizing the residual stones, we conducted SPY-DS-guided electrohydraulic lithotripsy. The stones were disintegrated and completely removed. In cases of PDCS failure, a treatment strategy using the SPY-DS can be considered for patients with hepatolithiasis after a Whipple procedure. Clin Endosc 2018;51:596-599
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subjects Cholangioscopy
Hepatolithiasis
SpyGlass digital system
Whipple procedure
title Treatment Using the SpyGlass Digital System in a Patient with Hepatolithiasis after a Whipple Procedure
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