Thursday, January 2, 2014

A very long biliary stricture secondary to cholangiocarcinoma

This 54 year old gentleman had obstructive jaundice due to a metastatic cholangiocarcinoma and was due to undergo placement of a self expanding metallic stent. Going in, we were welcomed by a worm at the junction of bulb and descending duodenum (A: white arrow). Contrast injection showed a sharp cutoff above the mid CBD (B: white arrow). The guidewire was placed across the strictured segment after some maneuvering and contrast injection showed the extent of the stricture (C: white arrows) and dilated intrahepatic ducts. The stent assembly was then positioned across the tumor area (D: white arrows). A 10 mm wide 10 cm long uncovered self expanding metallic stent was deployed (E: white arrows).

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Second (actually 3rd) ERCP for post transplant biliary leak

This 60 year old gentleman had earlier undergone ERCP and stenting for an anastomotic biliary leakage a few months earlier http://ercp365.bl...