Supine-Position Endoscopic Retrograde Cholangiopancreatography for a Patient With Severe Motor and Intellectual Disabilities

A 64-year-old man was referred to our hospital for obstructive jaundice and acute cholangitis. He had severe motor and intellectual disabilities associated with cerebral palsy and required full assistance with activities of daily living due to right hemiplegia and limb contracture. Considering the risks associated with the prone position, endoscopic retrograde cholangiopancreatography (ERCP) was performed in the supine position. Cholangiography revealed stricture of the perihilar bile duct (Figure A) and double endoscopic nasobiliary drainage was performed (Figure B).