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After one day of conservative management, the patient is transferred to the operating room for aspiration of the collection. A large vacuum drain is inserted into the collection. Then an endoscopic sphincterotomy (EST) is performed, placing a 7Fr. 10 cm long soft duodenoscope (Spyglass 2T, Boston Scientific, Boston, Mass, USA) and the stone basket (Hemospray, Boston Scientific, Boston, Mass, USA). Due to the presence of a stone in the common bile duct, without any papillary obstruction, cystic duct, and no abnormalities of the biliary tree, it is decided to perform a choledochoscopy ( Fig. 2 ). After that, cholangiocatheterization and removal of the stone are accomplished ( Fig. 4 ).
At one week the patient presents to the emergency department. He is alert and awake, with no fever. Laboratory tests are within normal range. A new CT-scan is performed, showing complete resolution of the collections. The intrahepatic ducts and the extrahepatic bile ducts are not dilated.
At the end of the first week of follow up, the patient is discharged. A new CT-scan is performed at one month follow up. At the end of the second month, the patient is asymptomatic and free of collections.
This poor server is compatible for Google Earth (5.2.2.6 and lower, 7.0.1.22 and lower), as well as any web-based video collection software. For those not interested in downloading the software, the server has been provided pre-configured to quickly seed your collection on to the public!
In addition, in order to expand this collection to the maximum, we also aim to collect the creation of all human beings, the true definition of “art”, through all the mediums that have ever been invented.
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