During a recent ERCP I had to “deliver" a tricky biliary stone and to do so I had to perform a “biliary episiotomy.” Background: an 87 year old man with Alzheimer’s disease was admitted with abdominal pain and sepsis. Blood tests indicated pancreatitis and CT scan/ MRCP showed stones in the gall bladder and a further stone impacted in the lower CBD. Hence an ERCP was performed.
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