Post written by Shailendra Singh, MD, and Ethan M. Cohen, MD, from the Department of Gastroenterology & Hepatology, West Virginia University, Morgantown, West Virginia, USA. We present a case of a 63-year-old woman who underwent a pancreaticoduodenectomy (Whipple procedure) for a rapidly expanding pancreatic head mass. Three years after the surgery, she developed severe persistent nausea and bilious emesis because …
Tag: EUS
Upside down in WONderland: EUS-guided upward insertion of a lumen-apposing metal stent via the third portion of the duodenum
Post written by Rintaro Fukuda, MD, from the Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, Yousuke Nakai, MD, PhD, from the Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, and the Department of Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital, Tokyo, Tomotaka Saito, MD, PhD, from the Department of Gastroenterology, Graduate …
EUS-guided hepaticogastrostomy: practical tips and tricks
Post written by Kambiz Kadkhodayan, MD, from the Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA, and Shayan Irani, MD, from Virginia Mason Franciscan Health, Seattle, Washington, USA. In recent years, EUS-guided hepaticogastrostomy (EUS-HGS) has gained traction as a reliable and safe method for definitive biliary drainage in patients who cannot undergo traditional transampullary procedures. Here, we highlight key clinical and …
Continue reading EUS-guided hepaticogastrostomy: practical tips and tricks
EUS- versus ERCP-guided biliary drainage for malignant biliary obstruction: a systematic review and meta-analysis of randomized controlled trials
Post written by Eduardo Cerchi Barbosa from the Department of Medicine, Evangelical University of Goiás, Anápolis, Brazil, and Gilmara Coelho Meine, MD, MSc, from the Division of Gastroenterology, Department of Internal Medicine, Feevale University, Novo Hamburgo, Brazil. Periampullary cancers carry a poor prognosis and often result in malignant biliary obstruction (MBO). Despite technological advances, few cases are resectable at the …
Disrupted pancreatic duct with pancreaticocutaneous fistula after percutaneous pseudocyst drain: conversion to internal drainage with transgastric stents
Post written by Saeed Ali, MD, from AdventHealth Orlando, Orlando, Florida, USA, and Brian Boulay, MD, MPH, from the Division of Gastroenterology and Hepatology, Department of Medicine, University of Illinois Hospital and Health Sciences Center, Chicago, Illinois, USA. This is an interesting case of a 67-year-old man who developed acute necrotizing pancreatitis followed by a 19-cm pseudocyst with a …
Editor’s Choice: EUS-guided thrombin injection and coil implantation for gastric varices: feasibility, safety, and outcomes
GIE Senior Associate Editor David L. Diehl, MD, highlights this article from the September issue: “EUS-guided thrombin injection and coil implantation for gastric varices: feasibility, safety, and outcomes” by Joanne O’Rourke, MBChB, et al. One of the pillars of endohepatology is EUS-guided treatment of gastric varices. Although endoscopic glue injection with cyanoacrylate (CYA) has been a standard approach for …
Modified submucosal tunneling endoscopic resection for the management of a large leiomyoma in the gastric fundus
Post written by Yasi Xiao, MD, and Dennis Yang, MD, from the Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA. We present a video of a 61-year-old woman with a symptomatic large subepithelial lesion (SEL) in the gastric fundus. This SEL was biopsied on EUS and found to be a leiomyoma. After multidisciplinary discussion with thoracic …
Definitive endoscopic repair of transected bile ducts after cholecystectomy using EUS-guided hepaticogastrostomy and retrograde cholangioperitoneoscopy
Post written by Manuel Perez-Miranda, MD, PhD, from Hospital Universitario Rio Hortega, Valladolid, Spain. A patient with a transected bile duct after cholecystectomy presenting with high-output bile leakage was successfully treated with staged endoscopy. EUS-guided hepaticogastrostomy was used first to internalize externally diverted bile flow. At a follow-up endoscopy, a cholangioscope by ERCP grasped a …
Retrograde endosonography for diagnosing imaging-occult cancer at the head of the pancreas in a patient with distal gastrectomy and Roux-en-Y reconstruction
Post written by Michael Lajin, MD, from Sharp HealthCare, San Diego, California, USA. A 73-year-old man with a history of distal gastrectomy presented with jaundice and 20-pound weight loss. Abdominal CT with intravenous contrast showed cholelithiasis and a dilated biliary tree without evidence of choledocholithiasis or neoplasm. MRCP was not possible because of shrapnel. He …
Fixation of the proximal flange of a lumen-apposing metal stent using a through-the-scope endoscopic suturing system to prevent stent migration in single-session EUS-directed transgastric ERCP: a pilot study
Post written by Hafiz Muzaffar Akbar Khan, MD, from the Division of Gastroenterology and Azhar Hussain, MBBS, from the Division of Medicine, State University of New York Upstate Medical University, Syracuse, New York, USA. The aim of our study was to evaluate and describe safe and effective use of a through-the-scope endoscopic suturing system for anchoring …
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