Open Access
CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(10): E1504-E1507
DOI: 10.1055/a-1191-2680
Case report

Real-time transabdominal ultrasound-guided ERCP is feasible and effective in pregnancy: a case series

Suqing Li
1   Division of Gastroenterology, Department of Medicine, The Center for Advanced Therapeutic Endoscopy and Endoscopic Oncology, St. Michael’s Hospital, Toronto, Canada
,
Callum Dargavel
1   Division of Gastroenterology, Department of Medicine, The Center for Advanced Therapeutic Endoscopy and Endoscopic Oncology, St. Michael’s Hospital, Toronto, Canada
,
Derek Muradali
2   Department of Medical Imaging, St Michael’s Hospital, Toronto, Canada
,
Gary R. May
1   Division of Gastroenterology, Department of Medicine, The Center for Advanced Therapeutic Endoscopy and Endoscopic Oncology, St. Michael’s Hospital, Toronto, Canada
,
Jeffrey D. Mosko
1   Division of Gastroenterology, Department of Medicine, The Center for Advanced Therapeutic Endoscopy and Endoscopic Oncology, St. Michael’s Hospital, Toronto, Canada
› Author Affiliations
Preview

Abstract

Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) is commonly required in pregnancy for choledocholithiasis, however, radiation exposure is a major concern for patients. Real-time transabdominal (TA) ultrasound (US)-guided ERCP is a radiation-free technique that facilitates confirmation of biliary cannulation, equipment exchange and stone clearance. We present the largest Western case series of this modality in pregnancy and a review of the literature.

Four pregnant adult patients were referred to our tertiary center with suspected or documented choledocholithiasis and underwent real-time TA US-guided ERCP. US was successfully used to confirm positioning of the guidewire and ductal clearance. Procedures were successful in all patients with resolution of clinical symptoms and no immediate procedural complications. Two patients suffered adverse events later in their pregnancy.

Real-time TA US-guided ERCP is a technically feasible and effective modality that can be offered to obtain biliary access in a radiation-free fashion for specific subsets of pregnant patients with choledocholithiasis. Future studies are needed to confirm the safety of this technique.



Publication History

Received: 04 January 2020

Accepted: 20 April 2020

Article published online:
07 October 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany