Post written by Ryosuke Tonozuka, PhD, MD, from the Department of Gastroenterology and Hepatology, at the Tokyo Medical University in Tokyo, Japan

This video shows antegrade therapy using this new digital per-oral cholangioscope (DPCS) through the EUS-guided hepaticogastrostomy (EUS-HGS) route for a stricture of the biliojejunal anastomotic site.

Digital per-oral cholangioscope with good visualization through the EUS-HGS route could detect a severe stricture of the biliojejunal anastomotic site, and antegrade dilation and stent placement were successful.

Recently, endoscopic ultrasonography (EUS)-guided biliary drainage has been developed as an alternative procedure to PTBD for a patient with a biliary anastomotic stricture in patients with surgically altered anatomy. However, sometimes the antegrade guidewire pass into the stricture of the anastomosis is difficult. This method is very useful for such a case.

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