Saturday, March 29, 2014

Follow up CBD clearance after initial clearing of pancreatic duct

This 18 year old lady underwent ERCP with pancreatic duct clearance a few days ago http://www.ercp365.blogspot.com/2014/03/managing-pancreatitis-with-blocked.html
At that time we hadn't been able to access the CBD. Going in now, the swelling had greatly subsided and we were bale to identify the bile duct clearly (A: black arrow indicates the CBD and white arrow shows the wide open pancreatic duct ). The CBD was cannulated (B: black arrow) followed by contrast injection (C) which outlined a normal calibre CBD with no negative shadows. We decided to do a sphincterotomy (D: white arrow) and swept the CBD with biliary balloon (E: white arrow shows the balloon inflated in the CBD). As suspected, it was a clean sweep and no stones or sludge was extruded.

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