Üstündag Y. | Karakaya K. | Aydemir S.

Article | 2009 | Turkish Journal of Gastroenterology20 ( 4 ) , pp.279 - 281

Endoscopic cannulation of the biliary tract may be challenging in cases with juxtapapillary, duodenal diverticula. A 70-year-old woman admitted to the hospital with the diagnosis of choledocholithiasis and acute cholangitis. She was placed on antibiotic treatment and parenteral fluid resuscitation. On endoscopic retrograde cholangiopancreatography, the papilla could not be cannulated because of the duodenal diverticulum. Various attempts at biliary cannulation failed. Endoscopic clips were used for evertion and fixation of a partially everted papilla from the diverticulum and for securing it in an orientation that allowed direct can . . .nulation of the biliary tree. Cholangiography demonstrated multiple calculi within the choledochus. She was discharged from the hospital on the 9th day following endoscopic retrograde cholangiopancreatography in good condition. With this report, we aimed to remind physicians that the clip-assisted method is a safe and effective technique for pancreatic and/or biliary cannulation, and should be preferred in patients in whom cannulation is extremely difficult due to large periampullary diverticula Daha fazlası Daha az

Engin H. | Üstündag Y.

Letter | 2009 | Turkish Journal of Gastroenterology20 ( 3 ) , pp.231 - 232

[No abstract available]

Üstündağ, Yücel | Karakaya, Kemal | Aydemir, Selim

Article | 2009 | Turkish Journal of Gastroenterology20 ( 4 ) , pp.279 - 281

Papilla bölgesinde duodenal divertikül olan hastalarda safra yollarının endoskopik kanülasyonu çok zor olabilmektedir. Yetmiş yaşında bir bayan hasta akut kolanjit ve koledokolithiazis tanılarıyla hastanemize başvurdu. Hastaya sıvı resüsitasyonu ve antibiyotik tedavisi başlandı. Endoskopik retrograd kolanjiyopankreatografide duodenal divertikül nedeniyle safra yolları kanüle edilemedi. Farklı girişimlere rağmen safra yolları kanüle edilemedi. Endoskopik klip yardımıyla divertikülden kısmen everte edilen papilla fikse edildi. Papillanın sabitlenmesi safra yollarının direkt kanulasyonuna imkan sağladı. Kolanjiografide koledokta multip . . .le kalkül izlendi. Sfinkterotomi, safra yollarından taş ekstraksiyonu yapılan hasta Endoskopik retrograd kolanjiyopankreatografiyi takip eden 9. gün iyi durumda taburcu edildi. Bu yazıda, özellikle büyük periampullar divertikül nedeniyle kanülasyonu çok zor olan olgularda, pankreas ve safra yollarının kanülasyonunda etkili ve güvenli bir yöntem olan endoskopik klip yardımıyla safra yolları kanülasyonu yöntemini hatırlatmak istedik. Endoscopic cannulation of the biliary tract may be challenging in cases with juxtapapillary, duodenal diverticula. A 70-yearold woman admitted to the hospital with the diagnosis of choledocholithiasis and acute cholangitis. She was placed on antibiotic treatment and parenteral fluid resuscitation. On endoscopic retrograde cholangiopancreatography, the papilla could not be cannulated because of the duodenal diverticulum. Various attempts at biliary cannulation failed. Endoscopic clips were used for evertion and fixation of a partially everted papilla from the diverticulum and for securing it in an orientation that allowed direct cannulation of the biliary tree. Cholangiography demonstrated multiple calculi within the choledochus. She was discharged from the hospital on the 9th day following endoscopic retrograde cholangiopancreatography in good condition. With this report, we aimed to remind physicians that the clipassisted method is a safe and effective technique for pancreatic and/or biliary cannulation, and should be preferred in patients in whom cannulation is extremely difficult due to large periampullary diverticula Daha fazlası Daha az

Engin, Hüseyin | Üstündağ, Yücel

Letter | 2009 | Turkish Journal of Gastroenterology20 ( 3 ) , pp.231 - 232

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