[Rescue technique for endoscopic extraction of biliary stent with proximal migration: "zipline - forceps"].

The endoscopic placement of a biliary stent presents adverse events, including proximal migration in the bile duct, a situation that can be so challenging to resolve that surgery must sometimes be resorted to. We present the case of a 83-year-old patient who underwent endoscopic retrograde cholangio pancreatography (ERCP) for acute cholangitis and a plastic biliary stent was placed for stenosis in the distal common bile duct. Four months later, proximal migration of the stent was evident; conventional extraction techniques were performed without success.

[The 5-5-2 criteria for biliary cannulation and post endoscopic retrograde cholangiopancreatography complications: Experience in a reference hospital, Peru].

The European Society for Gastrointestinal Endoscopy (ESGE) defines "difficult biliary cannulation" by the presence of one or more of the following: more than 5 contacts with the papilla, more than 5 minutes attempting to cannulate, or inadvertent cannulation of the pancreatic duct in 2 or more times (5-5-2 criteria), recommending these cut-off points to perform advanced cannulation techniques in order to reduce the rate of post-ERCP adverse events. Our objective was to evaluate the performance of the 5-5-2 criteria and their association with post-ERCP complications in a reference hospital in Peru. We performed a prospective analytical case-control study and 120 patients who underwent ERCP were enrolled.

[Clinical practice guideline for Diagnosis and management of cholelithiasis, cholecystitis and choledocholithiasis for the Peruvian Social Security (EsSalud)].

Introduction: This article summarizes the clinical practice guide (CPG) for the diagnosis and management of cholelithiasis, acute cholecystitis and choledocholithiasis in the Peruvian Social Security (EsSalud).

Objective: To provide clinical recommendations based on evidence for the management of patients with cholelithiasis, acute cholecystitis and choledocholithiasis in EsSalud.

Methods: a guideline task force (GTF) was formed with internists, general surgeons, gastroenterologists, and methodologists.