scholarly journals Endoscopic Ultrasound-Guided Pancreatobiliary Endoscopy in Surgically Altered Anatomy

2016 ◽  
Vol 49 (6) ◽  
pp. 515-529 ◽  
Author(s):  
Pichamol Jirapinyo ◽  
Linda S. Lee
Keyword(s):  
Endoscopic Ultrasound ◽  
Ultrasound Guided ◽  
Surgically Altered Anatomy

scholarly journals Antegrade Therapy for Management of Choledocholithiasis through Endoscopic Ultrasound-Guided Hepaticogastrostomy in a Patient with Surgically Altered Gastrointestinal Anatomy

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Robert Dorrell ◽  
Katelyn Madigan ◽  
Swati Pawa ◽  
Rishi Pawa
Keyword(s):  
Endoscopic Ultrasound ◽  
Biliary Drainage ◽  
Partial Gastrectomy ◽  
Biliary Tree ◽  
Ultrasound Guided ◽  
Electrohydraulic Lithotripsy ◽  
Surgically Altered Anatomy ◽  
History Of ◽  
Intraductal Therapy ◽  
Transhepatic Biliary Drainage

Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HG) is a technique used to access the biliary tree in patients with surgically altered anatomy. Additionally, development of EUS-HG fistula permits intraductal therapy, thereby preventing patients from requiring surgery or percutaneous transhepatic biliary drainage (PTBD), thus decreasing morbidity. This clinical vignette describes an 83-year-old man with a history of gangrenous cholecystitis requiring cholecystectomy, partial gastrectomy, and Roux-en-Y gastrojejunostomy who presented to an outside hospital with abdominal pain and fever and found to have cholangitis and choledocholithiasis. He underwent two endoscopic retrograde cholangiopancreatography (ERCP) procedures at an outside hospital which were unsuccessful due to an inaccessible major papilla in the setting of the patient’s surgically altered anatomy. On arrival to Wake Forest, the patient underwent EUS-HG with successful biliary drainage and resolution of cholangitis. He returned for ERCP three months later with balloon sphincteroplasty, cholangioscopy, and electrohydraulic lithotripsy (EHL) performed through the existing metal stent (hepaticogastrostomy), resulting in stone fragmentation and antegrade removal with balloon sweeps. Repeat cholangioscopy post-EHL and balloon sweeps showed complete duct clearance with no residual stones. The hepaticogastrostomy stent was subsequently removed, and the patient recovered without any complications.

Su1566 Endoscopic Ultrasound-Guided Antegrade Treatments for Biliary Disorders in Patients With Surgically Altered Anatomy

2013 ◽  
Vol 77 (5) ◽  
pp. AB370 ◽  
Author(s):  
Takuji Iwashita ◽  
Ichiro Yasuda ◽  
Shinpei Doi ◽  
Shinya Uemura ◽  
Masatoshi Mabuchi ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Ultrasound Guided ◽  
Surgically Altered Anatomy
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