EUS-guided blood patch delivery during liver biopsy: nature’s gel foam

Post written by Kenneth J. Chang, MD, from the Digestive Health Institute, Chao Family Comprehensive Digestive Disease Center, University of California, Irvine. These are 2 cases of EUS-guided liver biopsy where there was active blood flow within the needle tract prior to needle withdrawal. After waiting 2-3 minutes, we saw persistent flow, raising concerns that …

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Extracorporeal rendezvous technique combining endoscopic retrograde pancreatography with endoscopic ultrasound for main pancreatic duct disconnection arising from acute necrotizing pancreatitis

Post written by Toshiyasu Shiratori, MD, from the Department of Gastroenterology, Kameda Medical Center, Kamogawa City, Japan. This video shows an endoscopic pancreatic duct drainage technique combining ERCP with EUS using a percutaneous drainage route for main pancreatic duct disconnection that was difficult to traverse through the disconnected segment using either ERCP- or EUS-guided approaches. …

Continue reading Extracorporeal rendezvous technique combining endoscopic retrograde pancreatography with endoscopic ultrasound for main pancreatic duct disconnection arising from acute necrotizing pancreatitis

EUS-guided ethanol ablation of metastatic functional insulinoma

Post written by Ahmed Altonbary, MD, FRCP, from the Department of Gastroenterology and Hepatology, Mansoura Specialized Medical Hospital, Mansoura University, Mansoura, Egypt. We describe a case of EUS-guided ethanol ablation (EA) of metastatic functional insulinoma in a young male with recurrent attacks of hypoglycemia requiring intravenous glucose infusion.    Management of functioning pancreatic NETs is challenging; …

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Single-pass 1-needle actuation versus single-pass 3-needle actuation technique for EUS-guided liver biopsy sampling

Post written by David L. Diehl, MD, FACP, FASGE, from the Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, Pennsylvania, USA. The focus of this study is to further refine the optimal method for EUS-guided liver biopsy. Some reports in the literature utilize a single pass, single-needle throw for obtaining a liver biopsy specimen. …

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Editor’s Choice: Laparoscopic versus EUS-guided gastroenterostomy for gastric outlet obstruction

GIE Associate Editor, Dr. Fauze Maluf-Filho, highlights this article from the September issue “Laparoscopic versus EUS-guided gastroenterostomy for gastric outlet obstruction: an international multicenter propensity score–matched comparison” by Michiel Bronswijk, MD, et al. In this observational, multicenter study, the authors compared the outcomes of EUS-guided gastroenterostomy versus the gold standard intervention, laparoscopic gastroenterostomy, for the treatment …

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EUS-guided gallbladder drainage: Where will we go next?

Post written by Mihai Rimbaş, MD, PhD, and Alberto Larghi, MD, PhD, from the Gastroenterology Department, Colentina Clinical Hospital; the Department of Internal Medicine, Carol Davila University of Medicine, Bucharest, Romania; the Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS; and the Center for Endoscopic Research Therapeutics and Training, Catholic University, Rome, Italy. We …

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Magnetic compression anastomosis via EUS-guided hepaticogastrostomy for recanalization of complete common hepatic bile duct transection

Post written by Yingluk Sritunyarat, MD, from the Gastrointestinal Endoscopy Excellence Center, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. Traditionally, the treatment for bile duct transection is surgical-created bilio-enteric bypass. With recent advanced techniques to avoid the need for surgery, the magnetic-compression technique …

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EUS-guided biliary rendezvous as an emergent rescue after failed choledochoduodenostomy using a lumen-apposing metal stent

Post written by Joan B. Gornals, MD, PhD, from the Endoscopy Unit, Department of Digestive Diseases, Hospital Universitari de Bellvitge-IDIBELL, University of Barcelona, Catalonia, Spain. A 60-year-old man with pancreatic cancer and liver metastases who had been referred previously for biliary drainage was recommended palliative treatment. After a failed ERCP, same-session EUS-guided biliary drainage was …

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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 …

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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. …

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