A case in which repositioning based on intraductal ultrasonography was useful for trans-papillary gallbladder drainage

Abstract

An 88-year-old woman who visited the hospital with a complaint of right hypochondrial pain received a diagnosis of cholecystitis based on imaging findings. After hospitalization, endoscopic retrograde cholangiopancreatography and endoscopic trans-papillary gallbladder drainage (ETGBD) were performed. Although the cystic duct was not visualized even though imaging was performed after the choledocholithiasis was treated, intraductal ultrasonography (IDUS) was performed, and an air image mixed during the imaging was found on the cystic duct side. Contrast-enhanced imaging was not performed due to the opening above gravity, that is, on the dorsal side. When the position was changed from the prone position to the supine position, the cystic duct was easily visualized, the orifice of the cystic duct was grasped, and complete ETGBD was performed. It was suggested that ETGBD may have been successful due to repositioning the patient based on IDUS.