Post written by Azimudin Haja, MD, DM, Aniruddha Pratap Singh, DM, and Sundeep Lakhtakia, MD, DM, from AIG Hospitals, Hyderabad, India. Our case highlights the challenges faced in managing a patient with complex clinical problems several years after major surgery. The index patient who underwent curative pancreatoduodenectomy surgery 13 years ago for periampullary cancer presented with cholangitis because of a large …

Continue reading EUS-guided intervention in surgically altered anatomy to remove large biliary stone

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

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 …

Continue reading Definitive endoscopic repair of transected bile ducts after cholecystectomy using EUS-guided hepaticogastrostomy and retrograde cholangioperitoneoscopy

Post written by Hidenobu Hara, MD, from the Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan. EUS-guided hepaticogastrostomy (EUS-HGS) has become an effective method for biliary drainage, particularly in cases of hilar bile duct obstruction. This report presents the case of an 84-year-old woman with unresectable perihilar cholangiocarcinoma of bismuth type IV. …

Continue reading A novel method of bilateral biliary decompression by EUS-guided hepaticogastrostomy with bridging stenting using the partial stent-in-stent method for reintervention of multiple metal stent failure