ASGE DDW Videos from Around the World | 2022-ENDOSCOPIC ULTRASOUND GUIDED CHOLEDOCHODUODENOSTOMY USING A LUMEN-APPOSING METAL STENT IN A PATIENT WITH PRE-EXISTING DUODENAL STENT AND ASCITES

ENDOSCOPIC ULTRASOUND GUIDED CHOLEDOCHODUODENOSTOMY USING A LUMEN-APPOSING METAL STENT IN A PATIENT WITH PRE-EXISTING DUODENAL STENT AND ASCITES

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Video Transcription

Video Summary

This video discusses a case involving a 67-year-old female with metastatic breast cancer who presented with obstructive jaundice. Due to a distorted anatomy and pre-existing duodenal stent, traditional endoscopic procedures were not feasible. Endoscopic ultrasound-guided choledocal duodenostomy was performed using a lumen-opposing metal stent. The procedure involved puncturing the bowel duct with a cautery-enhanced lamps device, advancing a guide wire, and inserting the stent. The patient had no complications and experienced improved bilirubin levels. The use of a smaller-format lamps device allowed for precise stent placement and minimized the risk of bile leak. This technique shows promise for biliary decompression in similar cases. No credits were given in the transcript.

Keywords

metastatic breast cancer

obstructive jaundice

endoscopic ultrasound-guided choledocal duodenostomy

lumen-opposing metal stent

biliary decompression