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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Bilateral vs unilateral placement of metal stents for inoperable high-grade malignant hilar biliary strictures

Post written by Tae Hoon Lee, MD, PhD, and Jong Ho Moon, MD, PhD, from the Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, and the Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea. There is no definite consensus on whether bilateral placement of metal …

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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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Progressive learning in endoscopy simulation training improves clinical performance

Post written by Samir C. Grover, MD, MEd, FRCPC, from the Division of Gastroenterology, St. Michael’s Hospital Department of Medicine, University of Toronto, Toronto, Ontario, Canada. We aimed to improve existing simulation-based training curricula for teaching novices how to perform colonoscopy using progressive learning. We recognized that a theory-based approach to designing a curriculum in …

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The use of a LAMS for a short malignant duodenal stricture

Post written by Dennis Yang, MD, from the Division of Gastroenterology and Hepatology, University of Florida, Gainesville, Florida. A 59-year-old man with newly diagnosed metastatic pancreatic cancer was referred for endoscopic treatment of concomitant gastric outlet obstruction and malignant biliary obstruction. Endoscopy revealed a severe type I stricture. ERCP was performed with successful placement of …

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