Use of SpyGlass™ DS II Direct Visualization System With SpyBite™ Max Forceps for the Removal of Echinococcus Granulosus Causing Biliary Obstruction.

Hydatid disease, also known as cystic echinococcosis, affecting the liver can vary in clinical presentation from uncomplicated to most complicated one that can rupture into the bile duct. In the past, surgery was the mainstay of treatment for biliary complications. However, with the increasing expertise of endoscopic retrograde cholangiopancreatography, biliary complications are less common. Endoscopic retrograde cholangiopancreatography can be used preoperatively and postoperatively in patients presenting with jaundice to treat biliary obstruction and biliary fistula. In our case report, we illustrate the use of cholangioscopy with SpyGlass DS II Direct Visualization System (SpyGlass DS II; Boston Scientific) SpyBite Max forceps for complete removal of the parasite from the bile duct.