ASGE 2023 Masterclass EUS: Principles, Best Practices & Innovative Paradigms (Virtual) | February 2023-Pausawasdi_EUS Guided Biliary Drainage and Gastrojejunal Anastomosis

Pausawasdi_EUS Guided Biliary Drainage and Gastrojejunal Anastomosis

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This document is a summary of a presentation on EUS guided biliary drainage and gastrojejunal anastomosis. The presentation covers indications, contraindications, techniques, devices, and clinical outcomes of EUS guided biliary drainage (EUS-BD) and EUS guided gastrojejunal anastomosis (EUS-GJ).<br /><br />EUS-BD is indicated when ampullary access is failed or inaccessible, in cases of difficult access due to surgically altered anatomy, tumor infiltration of the ampulla, or the inability to visualize the bile duct. The presentation outlines the devices and accessories used for EUS-BD, including standard FNA needles, guidewires, dilators/cautery, balloons, and stents. The techniques for EUS-BD are described, including transduodenal and transhepatic routes of access. Complications and clinical outcomes of EUS-BD are also discussed.<br /><br />EUS-GJ is indicated for malignant gastric outlet obstruction (GOO) and is compared to surgical gastrojejunostomy (SGJ). The presentation describes five proposed techniques for EUS-GJ and outlines the equipment and devices necessary for the procedure. Clinical outcomes and safety profiles of EUS-GJ are also discussed, along with a comparison to SGJ.<br /><br />The presentation concludes with tips for EUS-BD and EUS-GJ, including proper echoendoscope position, use of the appropriate guidewire, flushing with saline, stent selection and positioning, and preferred techniques for EUS-GJ.<br /><br />Overall, the presentation provides a comprehensive overview of EUS guided biliary drainage and gastrojejunal anastomosis, including indications, techniques, devices, and clinical outcomes, serving as a valuable resource for practitioners in the field.

Keywords

EUS guided biliary drainage

EUS guided gastrojejunal anastomosis

indications

contraindications

techniques

devices

clinical outcomes

transduodenal access

transhepatic access

malignant gastric outlet obstruction