0000000000418648
AUTHOR
Volker Meves
Trans-Abdominal Ultrasound Guided ERC in a Pregnant Woman With Bile Duct Stones
Background: The change in lithogenicity of bile, increased stasis of bile and decreased gall bladder emptying are the possible reasons for an increased risk of gall stones during pregnancy. However, biliary interventions during pregnancy are associated with risks to both the pregnancy and developing fetus. ERC under fluoroscopic control as gold standard is associated with higher risk of premature labor and teratogenity. Methods and patient: We performed transabdominal ultra-sound guided ERC in one patient in the second trimenon with gall stones. While the hilus area is observed by ultrasound, the papilla is carefully cannulated with a guidewire. A contrast agent is applied in the common bil…
Prospective randomized comparison of short-access mother-baby cholangioscopy versus direct cholangioscopy with ultraslim gastroscopes
Mother-baby technologies, the criterion standard for cholangioscopy, have several limitations. A novel, short-access, mother-baby (SAMBA) system may improve this technique. Direct cholangioscopy (DC) was recently developed as an alternative to mother-baby cholangioscopy.Comparison of success rates with SAMBA and DC.Single-center, randomized, controlled trial.Academic tertiary-care referral center.Sixty patients with suspected cholangiopathies randomized to either SAMBA (n = 30) or DC (n = 30).Cholangioscopy under deep sedation.Technical success rate of diagnostic or therapeutic procedure.A total of 24 and 21 diagnostic procedures were performed in the SAMBA and DC groups, respectively. Ther…
Efficacy and safety of direct transnasal cholangioscopy with standard ultraslim endoscopes: results of a large cohort study.
Background Direct cholangioscopy (DC) with ultraslim endoscopes and free-hand cannulation of the common bile duct (CBD) is a promising technique for evaluating and treating cholangiopathy. However, its safety and success rates are as yet unclear. Objective To evaluate the overall success rates and adverse events with the procedure. Design Single-center, prospective cohort study; 12 patients retrospectively enrolled. Setting Academic tertiary referral center. Patients A total of 100 DC procedures in 84 patients with biliary disease were evaluated prospectively. Interventions DC performed with the patient under conscious sedation. Main Outcome Measurements Overall success rates and adverse ev…
The Short-Access Mother–Baby-(SAMBA) Cholangioscopy System
Conventional mother–baby cholangioscopy systems have significant limitations including poor image resolution, limited maneuverability and fragile cholangioscopes. We propose the novel short-access mother–baby-(SAMBA) cholangioscopy system that involves a very short and flexible cholangioscope that is introduced in a dedicated mother duodenoscope with an extra distal side port. Clinical feasibility of this device is demonstrated in three complex cases with cholangiopathies. The strengths of SAMBA cholangioscopy are improved imaging quality and excellent maneuverability of the baby that allows access of small intrahepatic ducts. Evaluation of suspected intrahepatic biliary disease is an excel…