In this episode, Dr. Alexander Vezeridis discusses advanced biliary interventions; covering stone removal procedures, technical success rates, and practical tips for using Spyglass cholangioscopy, laser lithotripsy, and endobiliary ablation. Dr. Vezeridis is an interventional radiologist, physician-scientist, and Assistant Professor of Radiology at Stanford.

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SYNPOSIS

Dr. Vezeridis highlights the importance of continuous learning, collaboration with other specialties, and shares his experiences and tips for optimizing patient outcomes. The doctors also touch on innovative approaches such as photodynamic therapy and the use of various tools in managing benign and malignant biliary diseases.

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TIMESTAMPS

00:00 - Introduction

03:25 - Setting Up Spyglass in Your Practice

10:50 - Patient Selection and Procedure Details

24:27 - Stone Fragmentation Techniques

27:35 - Success Rates and Patient Outcomes

35:06 - Endobiliary Ablation Techniques

47:35 - Laser Treatment for Biliary Obstructions

49:18 - Future Innovations

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RESOURCES

BackTable VI Podcast Episode #146 - Spyglass Interventions with Dr. Jeffrey Chick and Dr. Ravi Srinivasa:

https://www.backtable.com/shows/vi/podcasts/146/spyglass-interventions

Spyglass - Boston Scientific:

https://www.bostonscientific.com/en-US/medical-specialties/gastroenterology/advancements-cholangioscopy.html

Percutaneous Gallstone Removal: Long-term Follow-up (Dr. Hovsepian Paper):

https://www.jvir.org/article/S1051-0443(96)70766-2/pdf

SIR’s Percutaneous Cholangiopancreatoscopy (PCPS) registry:

https://clinicaltrials.gov/study/NCT05210322

StarMed Endoscopic RFA Clinical Articles:

https://www.starmedacademy.com/endoscopic-rfa-clinical-articles-elra

Habib Endobiliary Ablation Catheter:

https://www.bostonscientific.com/en-US/products/rf-ablation/habib-endohpb-bipolar-radiofrequency-catheter.html

Interventional Radiology-Operated Choledochoscopic-Guided Radiofrequency Wire and Holmium Laser Ablations May Facilitate Treatment and Long-Term Patency of Benign Biliary Strictures:

https://www.jvir.org/article/S1051-0443(18)31535-5/abstract

Percutaneous Cholangioscope-Assisted Laser Incision of Severe Benign Hepaticojejunostomy Stenoses:

https://pubmed.ncbi.nlm.nih.gov/35504434/

Percutaneous Endoluminal Benign Biliary Laser (PEBBL) (Clinical Trial):

https://clinicaltrials.gov/study/NCT05567003