“Two-devices-in-one-channel method” in a Roux-en-Y patient

Post written by Yohei Koyama, MD, from the Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. Balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP) has improved the outcomes of ERCP in patients with surgically altered anatomy. However, BE-ERCP requires high technical expertise, and biliary cannulation is often difficult. An 83-year-old man previously underwent total gastrectomy …

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ESD by use of a modified dental floss clip method for recurrent tumor in the cecum

Post written by Hisatomo Ikehara, MD, PhD, from the Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan. The patient in this video case underwent endoscopic submucosal dissection (ESD) for a recurrent tumor in the cecum 11 months after initial piecemeal endoscopic mucosal resection (p-EMR). The recurrent tumor showed …

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Insulated tip knife tunneling technique with clip line traction

Post written by Seiichiro Abe, MD, from the Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan. A 80-year-old male underwent endoscopic submucosal dissection (ESD) for a circumferential esophageal squamous cell carcinoma, 70 mm in size, involving the middle and lower esophagus. Using a dual knife and IT knife nano, a semi-circumferential mucosal incision was made …

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Esophageal stent placement without optical or fluoroscopic visualization

Post written by Michael M. Mwachiro, MBChB, from Tenwek Hospital, Bomet, Kenya. In this video, we describe the technique for placement of self-expanding metal stents (SEMS) for palliation of dysphagia due to esophageal malignancy without the use of optical or fluoroscopic visualization. The patient undergoes a video-endoscopic procedure to assess tumor length and proximal tumor …

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Successful EUS-guided nondilated pancreatic duct stent placement

Post written by Kazuhiro Minami, MD, from the Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan. Recently, the interventional EUS procedure has been performed in many facilities; however, EUS-guided pancreatic drainage (EUS-PD) remains extremely technically challenging. Generally, the normal pancreatic duct is too narrow to cannulate, and …

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Successful obliteration of bleeding duodenal varices by EUS-guided injection of N-butyl-2-cyanoacrylate

Post written by Yusuke Hashimoto, MD, from the Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan. This case describes a 76-year-old woman with unresectable pancreatic head cancer who presented with hematemesis that was complicated by multinodular duodenal varices originating from a posterior lower pancreatic vein viewed on CT scan. Banding …

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Endoscopic diagnosis of paraesophageal hernia with gastric volvulus

Post written by Harry R. Aslanian, MD, from Section of Digestive Diseases, Yale University School of Medicine, Yale University, New Haven, Connecticut, USA. A middle-aged man presented with episodic dysphagia and weight loss. Radiologic interpretation of an upper GI series and CT scan were inconclusive. Prior EGD reported inability to pass the scope out of …

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