Initial clinical experience of a steerable access device for EUS-guided biliary drainage

Post written by Vivek Kumbhari, MD, from the Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA. EUS-guided biliary drainage (EUS-BD) is an accepted method to treat biliary pathology in those that have failed ERCP. A recent consensus statement recommended that of the 4 major EUS-BD techniques, EUS-guided rendezvous should be the …

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Biliary reintervention with inversion technique in the duodenum with short-type double-balloon endoscope

Post written by Naminatsu Takahara, MD, PhD, and Yousuke Nakai, MD, PhD, from the Department of Endoscopy and Endoscopic Surgery, The University of Tokyo, Tokyo, Japan. A 51-year-old man was referred for the management of malignant biliary obstruction (MBO) and gastric outlet obstruction (GOO) due to pancreatic head cancer. A biliary covered metallic stent and …

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Hemostatic powder for the intraductal treatment of biliary cancer bleeding

Post written by Lorenzo Fuccio, MD, and Vito Sansone, MD, from the Gastroenterology Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, Bologna, Italy. The patient we described is a 87-year old woman, diagnosed with a Klatskin cholangiocarcinoma which was unsuitable for curative treatments, whom obtained a complete biliary drainage only after positioning …

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Comparison of endoscopic bilateral stent-in-stent vs stent-by-stent deployment

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, Republic of Korea. Although the efficacy of palliative bilateral biliary drainage using self-expandable metal stents (SEMS) has been demonstrated, it is unclear which bilateral deployment method using SEMS is …

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Endoclip papilloplasty for a patulous and incompetent biliary papilla

Post written by Yonghui Huang, MD, from the Department of Gastroenterology, Peking University International Hospital & Peking University Third Hospital, Beijing, China. An innovative endoscopic strategy was demonstrated for preserving the function of Oddi sphincter after large endoscopic sphincterotomy (EST) in a patient with a large stone of the CBD. After successful extraction of CBD …

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Recalcitrant embedded biliary self-expanding metal stents

Post written by Marc Bernon, MB, ChB, FCS, from the Surgical Gastroenterology Unit, Division of General Surgery, University of Cape Town Health Sciences Faculty and Groote Schuur Hospital, Cape Town, South Africa. Endoscopic placement of self-expanding metal stents (SEMS) is the palliative treatment of choice for obstructive jaundice due to malignant biliary obstruction. However, a …

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Crossing the minefield: EUS-guided transesophageal biliary rendezvous

Post written by Sundeep Lakhtakia, MD, DM, from the Asian Institute of Gastroenterology, Hyderabad, India. An elderly male presented with obstructive jaundice due to malignant distal biliary obstruction related to pancreatic head mass. There was associated portal vein thrombosis causing portal cavernoma and large esophago-gastric varices along with ascites. Repeated attempts to drain the obstructed …

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