Indication : This is an elective procedure performed for common bile duct obstruction
Place: Endoscopy room
Premed : Xylocaine throat spray 10%
Anesthesia : General anesthesia
Instrument : TJF-Q 180 V 55-2
Standard routine patient monitoring practice was observed. The side-viewing scope was passed into the esophagus stomach and the pylorus without difficulty. The ampulla of vater was identified.
Finding : There was a large mass at ampulla of vater extended tosecond part of duodenum connulation was done and cholagiogram revealed marked dilated common bile duct with short obstruction at distal CBD.
No filling defect seen Biopsy of ampulla was done. A 11.5 Fr. step dilator was applied to CBD.
A 10 Fr. 5 cm. double pigtail stent was inserted to CBD. Good bile flow was observed .
Intervention : Biopsy ampulla/sphincter of Oddi. Dilation ampulla of vater (sphincter of Oddi)/biliary duct Bile duct endoprosthesis
Pathology specimen : done at ampulla
Impression : CA Ampulla vater