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 …

Continue reading Successful EUS-guided nondilated pancreatic duct stent placement

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 …

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

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 …

Continue reading Successful obliteration of bleeding duodenal varices by EUS-guided injection of N-butyl-2-cyanoacrylate

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 …

Continue reading Endoscopic diagnosis of paraesophageal hernia with gastric volvulus

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 …

Continue reading Progressive learning in endoscopy simulation training improves clinical performance

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 …

Continue reading The use of a LAMS for a short malignant duodenal stricture

EUS-guided biliary drainage for internalization of percutaneous transhepatic biliary drainage

Post written by Ryan Law, DO, from the Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan. We present a case of a 59-year-old man with stage IV colorectal cancer with extensive metastatic disease to his liver who underwent EUS-guided internalization of his percutaneous transhepatic biliary drainage (PTBD) catheter utilizing an EUS-guided hepaticogastrostomy …

Continue reading EUS-guided biliary drainage for internalization of percutaneous transhepatic biliary drainage

Endoscopic jejunojejunostomy by use of a lumen-apposing self-expandable metal stent

Post written by Armin Küllmer, MD, from the Department of Medicine I, Klinikum Ludwigsburg, Ludwigsburg, Germany. We proudly present our video of an endoscopic jejunojejunostomy in order to bypass an obstructed efferent loop after subtotal gastrectomy with Roux-en-Y reconstruction. The endoscopic anastomosis was made using a lumen-apposing stent. The patient suffered from daily vomiting and …

Continue reading Endoscopic jejunojejunostomy by use of a lumen-apposing self-expandable metal stent

In “hot” pursuit of an evasive gallbladder

Post written by Lady Katherine Mejia Perez, MD, and Victoria Gomez, MD, from the Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida. We report an interesting case of a 75-year-old woman with decompensated cirrhosis with recurrent calculous cholecystitis who was being managed with an indwelling percutaneous cholecystostomy tube (PCT) due to poor surgical candidacy. …

Continue reading In “hot” pursuit of an evasive gallbladder

EUS-guided coiling of hepatic artery pseudoaneurysm in 2 stages

Post written by Malay Sharma, MD, DM, from the Jaswant Rai Specialty Hospital, Meerut, Uttar Pradesh, India. A 20-year-old man presented with right-upper quadrant abdominal pain for 2 months. He had undergone Ultrasound (US)-guided aspiration of a liver abscess 2 months previous. US of the abdomen showed a hepatic artery aneurysm. CT angiography (abdomen) confirmed …

Continue reading EUS-guided coiling of hepatic artery pseudoaneurysm in 2 stages