Cholangioscopy-guided removal of a proximally migrated biliary stent using a modified standard polypectomy snare 

Post written by Moamen Gabr, MD, MSc, from the Division of Digestive Diseases and Nutrition, University of Kentucky, Lexington, Kentucky. A 72-year-old male with diagnosis of pancreatic head adenocarcinoma requiring endoscopic biliary stent placement 2 weeks prior to admission presented with signs of biliary obstruction. Imaging showed proximal migration of a previously placed biliary stent. …

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Endoscopic radiofrequency ablation plus plastic stent placement versus stent placement alone for unresectable extrahepatic biliary cancer

Post written by Bing Hu, MD, PhD, from the Department of Gastroenterology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Yangpu District, and the Department of Gastroenterology, Third Affiliated Hospital, Second Military Medical University, Jiading District, Shanghai, China. The focus of our study is to compare the efficacy and safety between endoscopic radiofrequency ablation (RFA) …

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Modified double-guidewire technique using a unique double-lumen sphincterotome for difficult biliary cannulation

Post written by Hideyuki Shiomi, PhD, MD, from the Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. The double-guidewire technique (DGT) is considered as a promising salvage approach in difficult biliary cannulation cases. Nevertheless, with the interference of the pancreatic duct guidewire (P-GW) against cannulation devices, this technique …

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Bilateral balloon expandable biodegradable stent (Y-stent) for postcholecystectomy perihilar biliary stricture

Post written by Sundeep Lakhtakia, MD, DM, and Harsh Vardhan Tevethia, MD, DM, from the Department of Medical Gastroenterology, AIG Hospitals and Asian Institute of Gastroenterology, Hyderabad, Telangana, India. Following complicated laparoscopic cholecystectomy, a young woman developed a biliary stricture that required several ERCP sessions. She presented with recurrent jaundice. MRCP revealed a perihilar stricture …

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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 …

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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) …

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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 …

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