Novel biopsy forceps anchoring technique for completion of direct cholangioscopy after freehand intubation

Abstract

REFERENCES1 Lakhtakia S, Ramchandani M, Galasso D et al. EUS-guided radiofrequency ablation for management of pancreatic insulinoma by using a novel needle electrode (with videos). Gastrointest. Endosc. 2016; 83: 234-9. 2 Waung J, Todd J, Keane M, Pereira S. Successful management of a sporadic pancreatic insulinoma by endoscopic ultrasoundguided radiofrequency ablation. Endoscopy 2016; 48: 144-5. 3 Zhang WY, Zhao-Shen L, Zhen-Dong J. Endoscopic ultrasoundguided ethanol ablation therapy for tumors. World J. Gastroenterol. 2013; 19: 3397-403. 4 Park DH, Choi JH, Oh D et al. Endoscopic ultrasonographyguided ethanol ablation for small pancreatic neuroendocrine tumors: results of a pilot study. Clin. Endosc. 2015; 48: 158-64. 5 Trikudanathan G, Mallery SJ, Amateau SK. Successful endoscopic ultrasound-guided alcohol ablation of sporadic insulinoma using three-dimensional targeting (with video). Clin. Endosc. 2016; 49: 399-401.

Balloon catheter cannulation for route identification and axis stabilization during direct freehand cholangioscopy

“…Albeit navigation into the hilar region was not feasible (and in this case not mandatory) due to recurrent loop formation, switching from a simple balloon catheter to a biopsy forceps, for which anchoring and successful pulling up has been described ("the elevator technique") might have represented valid option. 10…”

Same-Session Direct Cholangioscopy Post-Mechanical Lithotripsy

“…2a). Therefore, the “biopsy-forceps anchoring” method was implemented, resulting in stable scope advancement up to the hilum [1] (Fig. 2b, c).…”

The “Bilio-Papillary Z Line”: Proposal for a Novel Quality Indicator of Direct Cholangioscopy

“…A novel quality indicator of DC, described in its freehand fashion without ancillary techniques, is being proposed and illustrated [ 2 ]: the “bilio-papillary Z line” reminiscent of its more easily accessible esophago-gastro-duodenoscopy counterpart. A 360° visualization of the bilio-papillary junction, in particular its medio-cranial aspects, remains difficult to achieve with currently established techniques ( Fig.…”