ASGE DDW Videos from Around the World | 2025-COMBINED ERCP AND EUS-GUIDED PALLIATIVE BILIARY DRAINAGE IN ALTERED ANATOMY

COMBINED ERCP AND EUS-GUIDED PALLIATIVE BILIARY DRAINAGE IN ALTERED ANATOMY

Video Transcription

Video Summary

A 37-year-old woman with metastatic GI adenocarcinoma and altered anatomy from previous surgeries underwent a combined ERCP and EUS-guided procedure for palliative biliary drainage. Due to malignant hilar obstruction, an uncovered metal stent was placed in her right hepatic duct via ERCP, while a fully covered metal stent and coaxial plastic stent were placed in her left hepatic duct via EUS-guided hepatico-gastrostomy. This approach addressed her symptoms effectively, maintaining normal liver enzyme levels and stable stent positioning at an 8-month follow-up. Such combined methods offer substantial benefits for managing complex biliary obstructions with altered anatomy.

Asset Subtitle

Khushboo Gala

Meta Tag

Concept Malignant Hilar Biliary Obstruction

Concept Roux-en-Y Anatomy

Concept Endoscopic Retrograde Cholangiopancreatography

Concept Endoscopic Ultrasound-Guided Biliary Drainage

Concept Combined Biliary Drainage

Keywords

ERCP

EUS-guided procedure

palliative biliary drainage

metal stent

hepatico-gastrostomy

Malignant Hilar Biliary Obstruction

Roux-en-Y Anatomy

Endoscopic Retrograde Cholangiopancreatography

Endoscopic Ultrasound-Guided Biliary Drainage

Combined Biliary Drainage