Conclusion: EUS was useful in avoiding substantial number of unnecessary diagnostic ERCP even in patients with severe acute pancreatitis and high clinical suspicion of CBD stones. Key Word(s): 1. EUS; 2. ERCP; 3. Acute Pancreatitis; 4. Choledocholithiasis; Presenting Author: P S RAJAN Additional Authors: C PALANIVELU, P SENTHILNATHAN,
P KARTHIKEYAN Corresponding Author: P S RAJAN Affiliations: GEM Hospital & Research Centre Objective: Laparoscopy Assisted Endoscopic Retrograde Cholangiography (LAERC) allows the diagnosis and treatment of biliopancreatic conditions in patients with altered anatomy following any kind of Roux-En-Y reconstruction. However experience with this technique is limited and its results are still emerging. Methods: To report on the experience with LAERC in consecutive ABT-263 research buy patients from a tertiary centre with high-volume of bariatric surgeries and to evaluate success rates of ERC with the laparoscopy-assisted approach. Results: Five patients underwent LAERC, three for choledocholithiasis after RYGB, one for recurrent stricture
after hepaticojejunostomy for choledochal cyst and one for choledocholithiasis following subtotal Gastrectomy. Endoscopic access was obtained through the gastric remnant (in three RYGB pts) or biliopancreatic limb (in other two patients). Biliary cannulation was successfully achieved in all the patients. Biliary sphincterotomy was performed in the three patients with intact sphincters. Average time taken to Lepirudin achieve laparoscopic assisted endoscopic cannulation was 40 min Selleckchem Y27632 (range 20 min–55 min) and average time
taken to complete the entire procedure was 140 minutes (range 110 min ? 160 min). All the four choledocholithiasis patients were treated by balloon sweep, and wide sphincterotomy. The patient with recurrent cholangitis following hepaticojejunostomy stricture for choledochal cyst managed with stenting. The median post procedure hospital stay was 4 days. Conclusion: LAERC is safe and successful for the treatment of biliopancreartic condition in patients with Roux-en- Y anatomy. Key Word(s): 1. Laparoendoscopy; 2. ERCP; 3. Stricture CHD; 4. CBD stones; Presenting Author: P S RAJAN Additional Authors: C PALANIVELU, S RAJAPANDIAN, P SENTHILNATHAN Corresponding Author: P S RAJAN Affiliations: GEM Hospital & Research Centre; GEM Hospital & Research Centre; GEM Hospital & Research Centre; GEM Hospital & Research Centre Objective: Post cholecystectomy with biliary peritonitis is a challenging clinical scenario where there is role of both surgery and endoscopy needed. Many a times, they were indeed performed separately. Our objective of this study is to see the feasibility and advantages in aiding fast recovery by combining both laparoscopic peritoneal lavage and ERCP with stenting at one stage. Methods: From September 2008 to January 2013, 43 patients with suspected biliary injury presented with peritonitis in our Institute.