Post written by Darshan Parekh, MS, from Mumbai Institute of Gastroenterology, Mumbai, India, and Ken Ohata, MD, PhD, from NTT Medical Center Tokyo, Tokyo, Japan. An 80-year-old man underwent resection of an approximately 30-mm ampullary tumor by endoscopic submucosal dissection (ESD). Post-ESD biliary and pancreatic diversion was attempted, but the ampullary opening could not be visualized in the post-ESD ulcer. Hence, …
Tag: EUS
EUS-guided pancreaticoduodenostomy using a lumen-apposing metal stent as a primary approach to treat difficult pancreatolithiasis: creating a side door to unlock the front door
Post written by Michael Lajin, MD, from Sharp HealthCare, San Diego, California, USA. A 55-year-old man with chronic calcific pancreatitis presented with abdominal pain and 12-pound weight loss. Abdominal CT and MRCP showed a large burden of calcified obstructive pancreatic duct (PD) stones above the papilla resulting in upstream PD dilatation measuring 19 mm. We discussed the …
EUS-guided radiofrequency ablation for pancreatic adenocarcinoma
Post written by Curtis J. Wray, MD, MS, from the Department of Surgery, Section of Surgical Oncology, and Nirav Thosani, MD, from the Department of Surgery, Section of Interventional Gastroenterology, University of Texas Health Science Center at Houston, Houston, Texas, USA. This manuscript details our initial institutional experience using EUS-guided radiofrequency ablation (EUS-RFA) combined with systemic chemotherapy for treatment …
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Peroral cholecystoscopy–guided interventions through a lumen-apposing metal stent after EUS-guided gallbladder drainage: proof-of-concept study in a swine model
Post written by Naminatsu Takahara, MD, PhD, from the Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Diagnosing gallbladder neoplasms is challenging because of difficulties in direct visualization and tissue sampling of the tumor. As a result, cholecystectomy is sometimes performed as a diagnostic procedure, but it can result in unnecessary surgery, which …
Endoscope traction technique to facilitate over-the-wire biliary cannulation during EUS-guided rendezvous
Post written by Ahmed Altonbary, MD, FRCP, FESGE, from Mansoura Specialized Medical Hospital, Mansoura University, Mansoura, Egypt. We describe the "endoscope traction" technique to facilitate over-the-wire biliary cannulation during EUS-guided rendezvous, an effective salvage technique for failed biliary cannulation during ERCP. Technically challenging steps in this technique include biliary puncture, guidewire manipulation, and biliary cannulation using the …
Endoscopic Braun enteroenterostomy for the management of severe bile acid reflux following Whipple surgery
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 …
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 …
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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 …
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