EUS-guided transhepatic biliary drainage: a large single-center U.S. experience

Post written by Todd H. Baron, MD, from the Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.  This study focused on transhepatic biliary drainage using endoscopic ultrasound for management of benign and malignant biliary obstruction. Although EUS-guided hepaticogastrostomy was first described nearly 20 years ago, almost …

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EUS-guided hepaticogastrostomy using a rendezvous technique to treat left intrahepatic duct stones in a patient with recurrent pyogenic cholangitis

Post written by Michael Lajin, MD, from SHARP Health, San Diego, California, USA. A 51-year-old male presented with abdominal pain due to recurrent pyogenic cholangitis. MRCP showed severe intrahepatic ductal dilatation involving the lateral segment of the left liver lobe with multiple intraductal stones. A transpapillary cholangioscope was unable to reach the targeted peripheral ducts.   …

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Recanalization after biliojejunostomy using new digital per-oral cholangioscope

Post written by Ryosuke Tonozuka, PhD, MD, from the Department of Gastroenterology and Hepatology, at the Tokyo Medical University in Tokyo, Japan This video shows antegrade therapy using this new digital per-oral cholangioscope (DPCS) through the EUS-guided hepaticogastrostomy (EUS-HGS) route for a stricture of the biliojejunal anastomotic site. Digital per-oral cholangioscope with good visualization through the EUS-HGS route …

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YAG laser lithotripsy for impacted stone

Ryosuke Tonozuka, MD, from the Department of Gastroenterology and Hepatology at Tokyo Medical University in Tokyo, Japan presents this VideoGIE case, "Holmium: YAG laser lithotripsy through an EUS-guided hepaticogastrostomy route." Treatment of biliary calculi in patients with surgically altered anatomy is often challenging despite the development of balloon enteroscopy (BE). This video showed holmium: YAG …

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