Dr. Michael Chew @mchew85
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GrepMed Gastroenterology-Hepatology Editor, Academic Hospitalist UC Davis Medical Center Internal Medicine, Yale Gastroenterology Fellow '22
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Common Bile Duct Biliary Stone removal on ERCP

Dr. Joaquín Berrueta Mezzera @DrJBerrueta

#Biliary #Stone #removal #extraction #ERCP
Common Bile Duct Biliary ... Stone removal on ERCP ... DrJBerrueta #Biliary ... removal #extraction #ERCP
Cholangiogram Biliary Anatomy on ERCP

#Cholangiogram #Biliary #Anatomy #hepatology #ercp
Cholangiogram Biliary ... Anatomy on ERCP ... Cholangiogram #Biliary ... Anatomy #hepatology #ercp
Difficult Selective Biliary Cannulation (SBC)
Factors associated with difficult SBC:
 - SMALL PAPILLA: can be difficult to
Difficult Selective Biliary ... site - OTHERS: biliary ... #Selective #Biliary ... SBC #Difficult #ercp
Causes of Severe Acute Liver Injury
 - Ichemic hepatitis
 - Acute biliary obstruction
 - Drug-Induced liver
hepatitis - Acute biliary ... Hemochromatosis - Primary biliary
Endoscopic Bleeding Risk - Summary points from ASGE guideline 

Low Risk Procedures 
 - Diagnostic endoscopy
enteroscopy - ERCP ... resection - ERCP
Primary Biliary Cirrhosis - Pathophysiology
Environmental Risk Factors: Geographic location, Smoking, Microbial triggers, Xenobiotics, Nail polish
Epigentics Risk
Primary Biliary ... inflammation and biliary ... #PBC #Primary #Biliary
Abnormal liver function tests algorithm.
 This figure details the initial response to abnormal liver blood tests.
Abnormal liver function ... initial response to abnormal ... *Abnormal USS may ... include extrahepatic biliary ... #LFTs #Abnormal
Gallstone Diseases
1. Asymptomatic Stones 75%
2. Biliary Pain 20%
3. Acute Cholecystitis 10%
4. Mirizzi's Syndrome < 0.1%
5. Cholangitis/
Biliary Pain 20%
Antibiotic Prophylaxis for Endoscopy (ASGE 2015) 

Give Antibiotics: 
 - PEG tube placement (or PEG-J)
mediastinal cysts - Biliary ... without cholangitis: ERCP ... transplant getting ERCP ... GI tract) - Biliary ... without cholangitis: ERCP
Primary Biliary Cirrhosis - Diagnosis Algorithm
Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort
Signs: Jaundice, Xanthelasmata, Hepatomegaly
Associated history:
Primary Biliary ... #PBC #Primary #Biliary