Injection of carbon dioxide instead of iodinated contrast to display the common bile duct during endoscopic retrograde cholangiopancreatography

Common bile duct (CBD) stones are usually caused by biliary tract infection, biliary stricture, duodenal peripapillary diverticulum, Oddis sphincter dysfunction, and so on. Treatment is preferably with endoscopic retrograde cholangiopancreatography (ERCP), where an iodine-containing contrast agent i...

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Main Authors: Cui Liu, Lingyun Tian, Xingyu Ze, Ting Yang, Luowei Wang, Zhaoshen Li
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Journal of Minimal Access Surgery
Subjects:
Online Access:https://journals.lww.com/10.4103/jmas.jmas_286_23
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author Cui Liu
Lingyun Tian
Xingyu Ze
Ting Yang
Luowei Wang
Zhaoshen Li
author_facet Cui Liu
Lingyun Tian
Xingyu Ze
Ting Yang
Luowei Wang
Zhaoshen Li
author_sort Cui Liu
collection DOAJ
description Common bile duct (CBD) stones are usually caused by biliary tract infection, biliary stricture, duodenal peripapillary diverticulum, Oddis sphincter dysfunction, and so on. Treatment is preferably with endoscopic retrograde cholangiopancreatography (ERCP), where an iodine-containing contrast agent is injected into the CBD to display the stone under fluoroscopy and then to confirm complete removal of the stone(s). We described a 65-year-old woman with CBD stones who had undergone cardiac pacemaker implantation and was allergic to iodinated contrast media. We performed ERCP + lithotomy + stent implantation under local anesthesia, with injection of carbon dioxide instead of iodinated contrast into the CBD, and successfully visualized the stones under fluoroscopy and then confirmed complete removal of them. The patient was generally in good condition without complications. Thus, we have demonstrated in this case report that carbon dioxide can be used as a safe, economical, and effective alternative to iodinated contrast agent during ERCP.
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issn 0972-9941
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language English
publishDate 2025-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Journal of Minimal Access Surgery
spelling doaj-art-5b86fcfe6f6140d389d3dab66b2723e72025-08-20T03:11:32ZengWolters Kluwer Medknow PublicationsJournal of Minimal Access Surgery0972-99411998-39212025-01-01211838510.4103/jmas.jmas_286_23Injection of carbon dioxide instead of iodinated contrast to display the common bile duct during endoscopic retrograde cholangiopancreatographyCui LiuLingyun TianXingyu ZeTing YangLuowei WangZhaoshen LiCommon bile duct (CBD) stones are usually caused by biliary tract infection, biliary stricture, duodenal peripapillary diverticulum, Oddis sphincter dysfunction, and so on. Treatment is preferably with endoscopic retrograde cholangiopancreatography (ERCP), where an iodine-containing contrast agent is injected into the CBD to display the stone under fluoroscopy and then to confirm complete removal of the stone(s). We described a 65-year-old woman with CBD stones who had undergone cardiac pacemaker implantation and was allergic to iodinated contrast media. We performed ERCP + lithotomy + stent implantation under local anesthesia, with injection of carbon dioxide instead of iodinated contrast into the CBD, and successfully visualized the stones under fluoroscopy and then confirmed complete removal of them. The patient was generally in good condition without complications. Thus, we have demonstrated in this case report that carbon dioxide can be used as a safe, economical, and effective alternative to iodinated contrast agent during ERCP.https://journals.lww.com/10.4103/jmas.jmas_286_23carbon dioxidecommon bile duct stonedigestive system diseasesiodinated contrastminimal access surgerystonesendoscopic retrograde cholangiopancreatography
spellingShingle Cui Liu
Lingyun Tian
Xingyu Ze
Ting Yang
Luowei Wang
Zhaoshen Li
Injection of carbon dioxide instead of iodinated contrast to display the common bile duct during endoscopic retrograde cholangiopancreatography
Journal of Minimal Access Surgery
carbon dioxide
common bile duct stone
digestive system diseases
iodinated contrast
minimal access surgery
stonesendoscopic retrograde cholangiopancreatography
title Injection of carbon dioxide instead of iodinated contrast to display the common bile duct during endoscopic retrograde cholangiopancreatography
title_full Injection of carbon dioxide instead of iodinated contrast to display the common bile duct during endoscopic retrograde cholangiopancreatography
title_fullStr Injection of carbon dioxide instead of iodinated contrast to display the common bile duct during endoscopic retrograde cholangiopancreatography
title_full_unstemmed Injection of carbon dioxide instead of iodinated contrast to display the common bile duct during endoscopic retrograde cholangiopancreatography
title_short Injection of carbon dioxide instead of iodinated contrast to display the common bile duct during endoscopic retrograde cholangiopancreatography
title_sort injection of carbon dioxide instead of iodinated contrast to display the common bile duct during endoscopic retrograde cholangiopancreatography
topic carbon dioxide
common bile duct stone
digestive system diseases
iodinated contrast
minimal access surgery
stonesendoscopic retrograde cholangiopancreatography
url https://journals.lww.com/10.4103/jmas.jmas_286_23
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