Combined bridging and antegrade stent placement during transmural treatment for malignant hilar biliary obstruction in a patient with surgically altered anatomy

Post written by Hassan Atalla, MSc, and Hideyuki Shiomi, MD, PhD, from the Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan, and Hepatology and Gastroenterology Unit, Department of Internal Medicine, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt. A 69-year-old woman who had undergone a distal gastrectomy combined …

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EUS-guided gastrojejunostomy and hepaticogastrostomy for malignant duodenal and biliary obstruction

Post written by Kevin D. Platt, MD, and Ryan J. Law, DO, from the Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA. Our case describes a 59-year-old woman with metastatic ovarian cancer who presented with nausea with vomiting and jaundice secondary to a large mesenteric mass that was causing both gastric outlet and …

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EUS-guided choledochoduodenostomy as a rescue after failed ERCP and percutaneous transhepatic biliary drainage in the management of postoperative benign biliary stricture

Post written by Sundeep Lakhtakia, MD, MNAMS, DM, FASGE, from the Department of Medical Gastroenterology, AIG Hospitals and Asian Institute of Gastroenterology, Hyderabad, Telangana, India. A young woman who had surgical choledocho-duodenostomy 5 years ago for biliary adverse events soon after cholecystectomy presented with biliary obstruction. MRCP revealed a smooth mid-CBD stricture, intra-hepatic stone with …

Continue reading EUS-guided choledochoduodenostomy as a rescue after failed ERCP and percutaneous transhepatic biliary drainage in the management of postoperative benign biliary stricture

Overtube-guided electrohydraulic lithotripsy through digital cholangioscopy for difficult biliary stones in a postoperative patient

Post written by Hassan Atalla, MSc, and Arata Sakai, MD, PhD, from the Hepatology and Gastroenterology Unit, Department of Internal Medicine, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt, and the Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. A 60-year-old man with history of Roux-en-Y hepaticojejunostomy for …

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Endoscopic tamponade using a fully covered self-expandable metallic stent for massive biliary bleeding from a pseudoaneurysm rupture during metallic stent removal

Post written by Nao Fujimori, MD, PhD, from the Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. Hemobilia is a rare but life-threatening adverse event related to pancreato-biliary diseases, transhepatic percutaneous, or endoscopic interventions. The rupture of the pseudoaneurysm after a plastic stent or self-expandable metallic stents (SEMSs) …

Continue reading Endoscopic tamponade using a fully covered self-expandable metallic stent for massive biliary bleeding from a pseudoaneurysm rupture during metallic stent removal

A novel teaching tool for visualizing the invisible bile duct axis in 3 dimensions during biliary cannulation (Compact Disc method)

Post written by Mamoru Takenaka, MD, PhD, from the Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-sayama, Japan. The selective biliary cannulation is difficult to master, especially for cases of papillae with a long oral protrusion (LOP). In such cases, visualization of the invisible bile duct axis in 3 dimensions (3D) is …

Continue reading A novel teaching tool for visualizing the invisible bile duct axis in 3 dimensions during biliary cannulation (Compact Disc method)

Extrabiliary applications of fully covered antimigration biliary metal stents

Post written by Fateh Bazerbachi, MD, from the Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts. In this case series, our team demonstrates examples of luminal applications of specialized fully covered antimigration biliary stents in different challenging scenarios. Specifically, we apply these small-caliber stents in benign radiation pan-esophageal stricture, distal malignant esophageal stricture, enteral anastomotic …

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Digital single-operator peroral cholangioscopy-guided biopsy sampling versus ERCP-guided brushing for indeterminate biliary strictures

Post written by Mohan Ramchandani, MD, from the Asian Institute of Gastroenterology Hospitals, Hyderabad, India. The aim of this study was to assess the diagnostic accuracy of digital single-operator cholangioscopy (DSOC) compared with ERCP-based assessment using traditional sampling technology in patients with indeterminate biliary strictures (IBS). Indeterminate biliary stricture was defined as a suspected intrinsic …

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Removal of proximally migrated biliary stents by using single-operator cholangioscopy

Post written by Abed Al Lehibi, MD, from Gastroenterology and Hepatology, King Fahad Medical City, Riyadh, Saudi Arabia. Our series included 3 patients whose cases, while being treated for difficult biliary stones, were complicated by proximal stent migration. Two patients had migrated plastic stents, whereas the other had a migrated metal one. Single-operator cholangioscopy (Boston …

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Endotherapy of postcholecystectomy biliary strictures with multiple plastic stents

Post written by Andrea Tringali, MD, PhD, from the Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia, Digestive Endoscopy Unit, and the Università Cattolica del Sacro Cuore, Roma, Italia. Centre for Endoscopic Research Therapeutics and Training—CERTT. Our study is focused on a large series of patients treated by endoscopic insertion of multiple plastic stents (MPS) …

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