WEO Video: Prof. Guido Costamagna
Prof. Guido Costamagna performs ERCP a patient with a stricture of the biliary anastomosis following orthotopic liver transplantation (OLT)
Prof. Guido Costamagna from the Catholic University in Rome performs ERCP on a patient with a stricture of the biliary anastomosis following orthotopic liver transplantation (OLT). In this case, biliary cannulation proves difficult, but is eventually obtained with a guide wire. After access papillotomy, balloon dilation of the anastomotic stricture is performed and plastic stents are then inserted to dilate the stricture site. Stent exchanges after repeat dilations will be scheduled every 3 months, with increasing numbers of stents left in place until the stricture disappears, a process that typically takes 12-18 months. This technique of serial dilation and increasing stents for benign biliary strictures was pioneered by Dr Costamagna and his colleagues, and has now been widely adopted.
This video was taken during a live endoscopy session at the Digestive Endoscopy Unit, Catholic University, Rome, Italy.