Wiki ERCP Assistant

nelcap

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I need help with this report, I don't see a tube change or anything else I can code:

Procedure: I was called to assist Dr XX in a ERCP within the operating room. The patient had multiple duodenal diverticula making it difficult to identify the ampulla of Vater. The patient had a cholecystostomy tube in place. The tube and surrounding soft tissues were prepped and draped in the usual sterile fashion. An Amplatz wire was placed through the existing tube and negotiated through the cystic duct into the common bile duct. This would not pass into the duodenum. The catheter was then removed over the wire and a Berenstein catheter was used to negociate the wire into the duodenum after considered effort Dr XX was then able to grasp and secure this wire. The catheter was advance into the doudenum. This Amplatz wire was exchanged for an exchange length Amplatz wire. Dr XX was able to grasp this and pull it back through the mouth to assist in cannulating the common bile duct through the endoscope. The Berenstein catheter was removed.
After some time I was called back to de Operating Room as the original wire I had placed had broken. I placed a Berenstein catheter over the wire and replace it with a second wire Dr XX provided for continued endoscopic attempt at canulating the ampulla. At this time I left the procedure.

Thanks in advance
 
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