Contrast-enhanced US-guided ERCP for treatment of common bile duct stones in pregnancy

Non‐radiation endoscopic retrograde cholangiopancreatography in the management of choledocholithiasis during pregnancy

“…After the ERCP procedure with stone removal is carried out, a subsequent ultrasonographic examination confirms complete ductal clearance . Recently, contrast‐enhanced US‐guided ERCP for the treatment of CBD stones in pregnancy was reported . In this case report, an US contrast agent (sulfur hexafluoride microbubbles) was injected via the ERCP catheter to improve visualization of the CBD, and appeared to be an excellent alternative to fluoroscopy for the guidance of biliary cannulation.…”

“…However, abdominal US‐guided ERCP needs additional professional staff, equipment and training that restrict its wide application. Although the ultrasound contrast used in the case report has not been associated with fetal abnormalities or spontaneous abortion in laboratory animals, it is not known whether ultrasound contrast agents may be used safely during human pregnancies.…”

“…The results of NR-ERCP during pregnancy in the published studies are summarized in (Table 1). [11][12][13][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] Indications for this procedure in these patients were cholecystolithiasis, choledocholithiasis, biliary pancreatitis, cholangitis and biliary fistula. The non-radiation technique was used in all trimesters of pregnancy.…”

“…42 Recently, contrast-enhanced US-guided ERCP for the treatment of CBD stones in pregnancy was reported. 52 In this case report, an US contrast agent (sulfur hexafluoride microbubbles) was injected via the ERCP catheter to improve visualization of the CBD, and appeared to be an excellent alternative to fluoroscopy for the guidance of biliary cannulation. As previously noted, Huang et al 54 pro-posed that ultrasound-guided ERCP is preferred to empirical ERCP because of the higher stone clearance (89% vs 60%, P < 0.05) and lower complication rates (14% vs 3%, P < 0.05) reported in their non-randomized retrospective analysis.…”

Single‐operator cholangioscopy for the treatment of concomitant gallbladder stones and secondary common bile duct stones

“…2,3 There are different options for the treatment of concomitant gallbladder stones and secondary CBD stones. [4][5][6][7][8] Comparing with the traditional surgical treatments, such as open cholecystectomy or laparoscopic cholecystectomy (LC), along with CBD exploration, [9][10][11] endoscopic retrograde cholangiopancreatography (ERCP) followed by LC has become the most widely accepted treatment for concomitant gallbladder stones and secondary CBD stones. [5][6][7][8]12 However, there are some patients with concomitant gallbladder stones and secondary CBD stones, who have strong will to conserve gallbladder and refuse surgery, especially for young women.…”