EUS-guided hepaticogastrostomy for management of cholangitis, hepatolithiasis, and anastomotic stricture after Roux-en-Y hepaticojejunostomy

Post written by Rishi Pawa, MD, FACG, from the Wake Forest School of Medicine, Winston-Salem, North Carolina. A 43-year-old woman with history of Roux-en-Y hepaticojejunostomy (secondary to Strasberg type E1 common bile duct injury at the time of her cholecystectomy) presented with cholangitis, hepatolithiasis, and hepaticojejunostomy (HJ) anastomotic stricture. She initially underwent an EUS-guided hepaticogastrostomy …

Continue reading EUS-guided hepaticogastrostomy for management of cholangitis, hepatolithiasis, and anastomotic stricture after Roux-en-Y hepaticojejunostomy

EUS-guided gastroenterostomy to treat gastric outlet obstruction in a patient with gastric lymphoma followed by pyloric recanalization using a rendezvous technique

Post written by Michael Lajin, MD, from Sharp Grossmont Hospital, La Mesa, California. A 66-year-old man was diagnosed with gastric lymphoma and received chemotherapy. He developed pulmonary tuberculosis and was started on TB medications. He presented with vomiting and 80-pound weight loss. Endoscopy revealed a pyloric ulcer resulting in outlet obstruction and proximal gastric ulcers. …

Continue reading EUS-guided gastroenterostomy to treat gastric outlet obstruction in a patient with gastric lymphoma followed by pyloric recanalization using a rendezvous technique

Comparison of EUS-guided endoscopic transpapillary and percutaneous gallbladder drainage for acute cholecystitis

Post written by Anthony Yuen Bun Teoh, FRCSEd (Gen), from the Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China. The optimal method of gallbladder drainage for acute cholecystitis in nonsurgical candidates is uncertain. The aim of the current study was to conduct a network meta-analysis comparing …

Continue reading Comparison of EUS-guided endoscopic transpapillary and percutaneous gallbladder drainage for acute cholecystitis

EUS-guided jejunojejunostomy to facilitate ERCP in a patient with unique Roux-en-Y gastric bypass anatomy

Post written by Ryan Law, DO, from the University of Michigan, Ann Arbor, Michigan. In our case presentation we describe a patient who presented to our institution with concern for biliary pathology in the setting of prior Roux-en-Y gastric bypass with an indwelling percutaneous biliary drain. Importantly, this patient underwent a sleeve gastrectomy prior to …

Continue reading EUS-guided jejunojejunostomy to facilitate ERCP in a patient with unique Roux-en-Y gastric bypass anatomy

EUS-guided gallbladder drainage versus laparoscopic cholecystectomy for acute cholecystitis

Post written by Anthony Yuen Bun Teoh, FRCSEd (Gen), from the Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR. EUS-guided gallbladder drainage (EUS-GBD) is a safe alternative to percutaneous cholecystostomy (PT-GBD) for acute cholecystitis. How the procedure compares to laparoscopic cholecystectomy (LC) is uncertain. The aim of …

Continue reading EUS-guided gallbladder drainage versus laparoscopic cholecystectomy for acute cholecystitis

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 …

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

Improved detection of liver metastasis using Kupffer-phase imaging in contrast-enhanced harmonic EUS in patients with pancreatic cancer

Post written by Kosuke Minaga, MD, PhD, and Masayuki Kitano, MD, PhD, from the Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, and the Second Department of Internal Medicine, Wakayama Medical University School of Medicine, Wakayama, Japan. The focus of this study was to assess the usefulness of Kupffer-phase imaging in contrast-enhanced …

Continue reading Improved detection of liver metastasis using Kupffer-phase imaging in contrast-enhanced harmonic EUS in patients with pancreatic cancer

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 …

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

EUS diagnosis of asymptomatic type III choledochal cyst

Post written by Mohannad Abou Saleh, MD, Catherine Vozzo, DO, and Prabhleen Chahal, MD, from the Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, Ohio. We describe the EUS diagnosis of a type IIIA choledochal cyst in an 81-year-old woman with a history of diabetes mellitus type II, hypertension, hyperlipidemia, GERD, and irritable bowel …

Continue reading EUS diagnosis of asymptomatic type III choledochal cyst

Single-step EUS-guided drainage of a pancreatic pseudocyst with a modified guidewire as a cystotome

Post written by Wei An, MD, Dan Wang, MD, and Liang-Hao Hu, MD, from the Department of Gastroenterology, ChangHai Hospital, The Second Military Medical University, Shanghai, China. A 69-year-old man with a history of chronic pancreatitis was referred to our hospital for severe abdominal distention and vomiting. Computed tomography revealed multiple pancreatic calcifications and a …

Continue reading Single-step EUS-guided drainage of a pancreatic pseudocyst with a modified guidewire as a cystotome