ASGE DDW Videos from Around the World | 2023-ENDOSCOPIC ULTRASOUND GUIDED TRANSHEPATIC RENDEZVOUS AND STENT PLACEMENT IN BENIGN BILIARY STRICTURE IN BILLROTH II ANATOMY AND PERIDIVERTICULAR PAPILLA

ENDOSCOPIC ULTRASOUND GUIDED TRANSHEPATIC RENDEZVOUS AND STENT PLACEMENT IN BENIGN BILIARY STRICTURE IN BILLROTH II ANATOMY AND PERIDIVERTICULAR PAPILLA

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Video Transcription

Video Summary

This video discusses a case of a 55-year-old man who had a distal gastrectomy two months prior and presented with persistent biliary-type pain. The patient had a dilated common bile duct with a stricture in the mid-distal CBD and a periampillary diverticulum. Due to the altered anatomy, cannulation using a duodenoscope was unsuccessful, so an EOS-guided rendezvous procedure was planned. The procedure involved puncturing the dilated intrahepatic bile ducts using a needle, negotiating a guide wire into the common hepatic duct, dilating the tract, and finally placing biliary stents. The patient experienced symptomatic relief and normalization of bilirubin levels after the procedure. The video highlights the challenges of ERCP in cases with altered anatomy and suggests alternative approaches. No specific credits were provided.

Asset Subtitle

Honorable Mention

Keywords

distal gastrectomy

persistent biliary-type pain

dilated common bile duct

periampillary diverticulum

EOS-guided rendezvous procedure