lisa.game@fdhs.com
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PLEASE ADVISE WHAT CODES TO ADD, IF ANY, FOR THE INTERVENTIONAL RADIOLOGY ASSISTANCE. NOT SURE IF I CAN.
PROCEDURE: Combined interventional radiology and GI procedure; endoscopic
retrograde cholangiopancreatography with sphincterotomy, balloon sweeps, and
plastic biliary stent placement.
INDICATIONS FOR PROCEDURE: Choledocholithiasis, obstructive jaundice.
OPERATIVE PROCEDURE DETAILS: Informed consent was obtained from the
patient after explaining all the risks, benefits and alternatives of the
procedure, which the patient appeared to understand and so stated. The
patient was connected to monitoring devices, sedated and intubated. The
patient was then placed in the prone position. A time-out was performed.
The scope was then passed in standard fashion from the mouth to the second
portion of the duodenum. The biliary drains were visualized.
Dr. X from Interventional Radiology passed the wire through the external biliary
drain. Once the wire was visualized endoscopically, the wire was grasped
with a snare and secured. The wire was then fed through the CannulaTome.
The CannulaTome was passed over the wire and cannulated the papilla which
was located within a diverticulum. The wire was secured and the biliary
drains were pulled.
A generous sphincterotomy was then made. An 11.5 mm
biliary balloon was then used to sweep the bile duct. Multiple large stones
were extracted. A balloon occlusion cholangiogram showed no filling defects
at the end of the sweeps. A 10-French x 5 cm plastic biliary stent was then
placed. Good bile flow was seen at the end of the procedure. The scope was
then completely removed and the procedure terminated. No complications noted
at the end of the procedure.
PROCEDURE: Combined interventional radiology and GI procedure; endoscopic
retrograde cholangiopancreatography with sphincterotomy, balloon sweeps, and
plastic biliary stent placement.
INDICATIONS FOR PROCEDURE: Choledocholithiasis, obstructive jaundice.
OPERATIVE PROCEDURE DETAILS: Informed consent was obtained from the
patient after explaining all the risks, benefits and alternatives of the
procedure, which the patient appeared to understand and so stated. The
patient was connected to monitoring devices, sedated and intubated. The
patient was then placed in the prone position. A time-out was performed.
The scope was then passed in standard fashion from the mouth to the second
portion of the duodenum. The biliary drains were visualized.
Dr. X from Interventional Radiology passed the wire through the external biliary
drain. Once the wire was visualized endoscopically, the wire was grasped
with a snare and secured. The wire was then fed through the CannulaTome.
The CannulaTome was passed over the wire and cannulated the papilla which
was located within a diverticulum. The wire was secured and the biliary
drains were pulled.
A generous sphincterotomy was then made. An 11.5 mm
biliary balloon was then used to sweep the bile duct. Multiple large stones
were extracted. A balloon occlusion cholangiogram showed no filling defects
at the end of the sweeps. A 10-French x 5 cm plastic biliary stent was then
placed. Good bile flow was seen at the end of the procedure. The scope was
then completely removed and the procedure terminated. No complications noted
at the end of the procedure.