Treatment Using the SpyGlass Digital System in a Patient with Hepatolithiasis after a Whipple Procedure.
- Author:
Hirofumi HARIMA
1
;
Kouichi HAMABE
;
Fusako HISANO
;
Yuko MATSUZAKI
;
Tadahiko ITOH
;
Kazutoshi SANUKI
;
Isao SAKAIDA
Author Information
- Publication Type:Case Report
- Keywords: Hepatolithiasis; Whipple procedure; Cholangioscopy; SpyGlass digital system
- MeSH: Aged, 80 and over; Bile Ducts, Intrahepatic; Cholangitis; Endoscopes; Endoscopes, Gastrointestinal; Humans; Lithotripsy
- From:Clinical Endoscopy 2018;51(6):596-599
- CountryRepublic of Korea
- Language:English
- Abstract: An 89-year-old man was referred to our hospital for treatment of hepatolithiasis causing recurrent cholangitis. He had undergone a prior Whipple procedure. Computed tomography demonstrated left-sided hepatolithiasis. First, we conducted peroral direct cholangioscopy (PDCS) using an ultraslim endoscope. Although PDCS was successfully conducted, it was unsuccessful in removing all the stones. The stones located in the B2 segment were difficult to remove because the endoscope could not be inserted deeply into this segment due to the small size of the intrahepatic bile duct. Next, we substituted the endoscope with an upper gastrointestinal endoscope. After positioning the endoscope, the SpyGlass digital system (SPY-DS) was successfully inserted deep into the B2 segment. Upon visualizing the residual stones, we conducted SPY-DS-guided electrohydraulic lithotripsy. The stones were disintegrated and completely removed. In cases of PDCS failure, a treatment strategy using the SPY-DS can be considered for patients with hepatolithiasis after a Whipple procedure.
