Spyglass Direct Visualization System facilitated management of iatrogenic biliary stricture: a novel approach in difficult cannulation

Abstract

A 70-year-old man with a history of cholelithiasis underwent laparoscopic cholecystectomy. At a follow-up visit 2 months later, he complained of epigastric pain and weight loss. Alkaline phosphatase, γ-glutamyl transferase, and bilirubin levels were all elevated. Magnetic resonance cholangiopancreatography showed a stricture in the middle of the common bile duct and dilatation above the stricture.