Category: VideoGIE

EUS-guided hepaticogastrostomy: practical tips and tricks

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Post written by Kambiz Kadkhodayan, MD, from the Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA, and Shayan Irani, MD, from Virginia Mason Franciscan Health, Seattle, Washington, USA. In recent years, EUS-guided hepaticogastrostomy (EUS-HGS) has gained traction as a reliable and safe method for definitive biliary drainage in patients who cannot undergo traditional transampullary procedures. Here, we highlight key clinical and …

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Disrupted pancreatic duct with pancreaticocutaneous fistula after percutaneous pseudocyst drain: conversion to internal drainage with transgastric stents

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Post written by Saeed Ali, MD, from AdventHealth Orlando, Orlando, Florida, USA, and Brian Boulay, MD, MPH, from the Division of Gastroenterology and Hepatology, Department of Medicine, University of Illinois Hospital and Health Sciences Center, Chicago, Illinois, USA. This is an interesting case of a 67-year-old man who developed acute necrotizing pancreatitis followed by a 19-cm pseudocyst with a …

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Antireflux mucosectomy as an effective treatment for GERD after laparoscopic sleeve gastrectomy

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Post written by Kazuki Yamamoto, MD, PhD, from the Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan. To our knowledge, this study reports the first instance of antireflux mucosectomy (ARMS) successfully treating GERD after laparoscopic sleeve gastrectomy (LSG). Although LSG is the most common bariatric procedure, accounting for up to 60% of global cases, it also …

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Modified submucosal tunneling endoscopic resection for the management of a large leiomyoma in the gastric fundus

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Post written by Yasi Xiao, MD, and Dennis Yang, MD, from the Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA. We present a video of a 61-year-old woman with a symptomatic large subepithelial lesion (SEL) in the gastric fundus. This SEL was biopsied on EUS and found to be a leiomyoma. After multidisciplinary discussion with thoracic …

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Biliary cast syndrome in Roux-en-Y hepaticojejunostomy anatomy

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Post written by Erica Park, MD, from the Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA. We describe a case of a patient who underwent an orthotopic liver transplantation from a donation after circulatory death. Dehiscence of the biliary anastomosis complicated her post-transplant course, requiring return to …

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Peroral endoscopic myotomy with diverticulotomy using a double tunnel technique: finding your way to an elusive lower esophageal sphincter in spastic achalasia and epiphrenic diverticulum

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Post written by Maham Hayat, MD, and Dennis Yang, MD, from the Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA. Our case is that of an 86-year-old woman with a history of achalasia and symptomatic epiphrenic diverticulum (ED) who was referred for peroral endoscopic myotomy (POEM) with simultaneous diverticulotomy. Endoscopy revealed a large ED and an …

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Addition of dilute epinephrine to commercially available submucosal lifting agents for cold snare EMR

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Post written by William Hirsch, MD, from the Division of Internal Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA, and Mohammad Bilal, MD, from the Division of Gastroenterology & Hepatology, Minneapolis VA Medical Center, University of Minnesota. Our video case details the process of adding dilute epinephrine to commercially available submucosa lifting agents. After …

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Successful endoscopic removal of a retained guidewire in the intrahepatic bile duct using a novel tapered sheath dilator

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Post written by Rintaro Fukuda, MD, and Naminatsu Takahara, MD, PhD, from the Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, and Yousuke Nakai, MD, PhD, from the Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo. Retained guidewire is not a rare adverse event …

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Definitive endoscopic repair of transected bile ducts after cholecystectomy using EUS-guided hepaticogastrostomy and retrograde cholangioperitoneoscopy

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Post written by Manuel Perez-Miranda, MD, PhD, from Hospital Universitario Rio Hortega, Valladolid, Spain. A patient with a transected bile duct after cholecystectomy presenting with high-output bile leakage was successfully treated with staged endoscopy. EUS-guided hepaticogastrostomy was used first to internalize externally diverted bile flow. At a follow-up endoscopy, a cholangioscope by ERCP grasped a …

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Enhancing stent length and stability with a novel through-the-scope suturing platform: a case series

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Post written by Shailendra Singh, MD, and Ayowumi A. Adekolu, MD, from West Virginia University, Morgantown, West Virginia, USA. We present a case series showing the use of a through-the-scope suturing (TTSS) system (X-Tack; Apollo Endosurgery, Austin, Tex, USA) for fixing 2 fully covered self-expandable metal stents (FCSEMSs) for creating longer stents as well as …

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