Percutaneous- and EUS-guided gastroenterostomy for malignant afferent limb syndrome

Post written by Dayyan Adoor, MD, and Zachary L. Smith, DO, from the Department of Internal Medicine and the Division of Gastroenterology and Liver Disease, University Hospitals Cleveland Medical Center, Cleveland, Ohio. A 66-year-old woman with poorly-differentiated pancreatic adenocarcinoma underwent a Whipple that was complicated by a biliary leak requiring placement of an internal external …

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Endoscopic treatment of symptomatic insulinoma with a new EUS-guided radiofrequency ablation device

Post written by Mihir S. Wagh, MD, FACG, FASGE, from the Division of Gastroenterology, University of Colorado-Denver School of Medicine, Aurora, CO, USA. We report EUS-guided ablation of symptomatic insulinoma with the newly available EUSRA device. Our video highlights the EUSRA device, the technique used for ablation, and successful clinical, physiologic, and radiologic results after …

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Lessons learned from a salvage procedure for LAMS misplacement during EUS-guided gastrojejunal bypass

Post written by Bruno Costa Martins, MD, PhD, from the Hospital Alemão Oswaldo Cruz, Endoscopy Unit, São Paulo, Brazil. We described a case of an 88-year-old patient with obstructive symptoms due to advanced head pancreatic neoplasm. EUS-guided gastrojejunal bypass (EUS-GJ) was chosen to palliate gastric outlet obstruction symptoms. EUS-GJ bypass was attempted with the aid …

Continue reading Lessons learned from a salvage procedure for LAMS misplacement during EUS-guided gastrojejunal bypass

Safety of EUS-guided gallbladder drainage using a LAMS in patients requiring anticoagulation

Post written by Catherine Frakes Vozzo, DO, and Prabhleen Chahal, MD, from the Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, Ohio. The purpose of our case series was to assess the safety of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) in patients requiring chronic anticoagulation. EUS-GBD is performed to treat acute cholecystitis in patients who …

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Randomized trial comparing fork-tip and side-fenestrated needles for EUS-guided fine-needle biopsy of solid pancreatic lesions

Post written by Stefano Francesco Crinò, MD, from the Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, Department of Medicine, G.B. Rossi University Hospital, Verona, Italy. Different needles for EUS-guided fine-needle biopsy (EUS-FNB) are currently available. Side-fenestrated and end-cutting types are both widespread and available in different calibers. This is the first randomized study directly …

Continue reading Randomized trial comparing fork-tip and side-fenestrated needles for EUS-guided fine-needle biopsy of solid pancreatic lesions

EUS-guided transrectal drainage of pelvic fluid collections using electrocautery-enhanced lumen-apposing metal stents

Post written by Andrea Lisotti, MD, from the Gastroenterology Unit, Hospital of Imola, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. Pelvic fluid collections (PFCs) are frequent adverse events of abdominal surgery or inflammatory conditions. Percutaneous approach for deep PFC could be challenging and could result in longer and painful recovery; trans-vaginal …

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EUS-guided rendezvous with a steerable access needle in choledocholithiasis

Post written by Sundeep Lakhtakia, MD, DM, from the Asian Institute of Gastroenterology, AIG Hosiptals, Telangana, India. A patient with past cholecystectomy presented with symptomatic CBD stones. He had unsuccessful ERCPs due to duodenal deformity and non-visualized papilla located within a large duodenal diverticulum. This video case has 2 interesting segments. In first part, EUS …

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Efficacy of EUS-guided celiac plexus neurolysis compared with medication alone for unresectable pancreatic cancer in the oxycodone/fentanyl era

Post written by Yoshihide Kanno, MD, from the Department of Gastroenterology, Sendai City Medical Center, Miyagi, Japan. The focus of our study was to evaluate the value of routine performance of EUS-guided celiac plexus neurolysis (EUS-CPN) at an early cancer-pain stage. EUS-CPN has been reported to be effective for patients with upper abdominal pain due …

Continue reading Efficacy of EUS-guided celiac plexus neurolysis compared with medication alone for unresectable pancreatic cancer in the oxycodone/fentanyl era

Gastric overtube use to prevent duodenoscope loop formation during EUS-directed transgastric ERCP procedure

Post written by Shelini Sooklal, MD, from the Division of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic Foundation, Cleveland, Ohio, USA. This video case demonstrates the technique of using a disposable gastric overtube device to aid passage of the duodenoscope through a previously placed lumen apposing metal stent (LAMS), from the roux limb to the remnant …

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Diagnostic yield of EUS-guided through-the-needle biopsy in pancreatic cysts

Post written by Antonio Facciorusso, MD, from the Gastroenterology Unit, University of Foggia, Foggia, Italy. The low sensitivity, reported to be as high as 54% in differentiating mucinous from non-mucinous pancreatic cystic lesions (PCLs), represents a major drawback of standard endoscopic ultrasound (EUS) fine-needle aspiration (FNA). Recently, a through-the-needle microforceps biopsy (TTNB) device that can …

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