ASGE DDW Videos from Around the World | 2025-EUS-DIRECTED ENTEROENTEROTOMY AND ENDOSCOPIC SUBMUCOSAL DISSECTION FOR A REFRACTORY HEPATICOJEJUNAL ANASTOMOTIC STRICTURE IN A LIVER

EUS-DIRECTED ENTEROENTEROTOMY AND ENDOSCOPIC SUBMUCOSAL DISSECTION FOR A REFRACTORY HEPATICOJEJUNAL ANASTOMOTIC STRICTURE IN A LIVER

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Video Summary

A 55-year-old liver transplant recipient faced biliary symptoms due to a hepatic jejunal anastomotic stricture. After exploring various treatment options, the patient underwent a multi-step endoscopic procedure involving EUS-directed gastrojejunal stenting followed by a choledochoduodenostomy using endoscopic submucosal dissection (ESD) for tissue destruction and stricturoplasty. Despite improvements, recurrent symptoms led to further ESD intervention. This case highlights the innovative use of endosonography, ERCP, and ESD to manage complex biliary strictures in patients with altered surgical anatomy, demonstrating the efficacy of combining these techniques in treating refractory conditions.

Asset Subtitle

Video Plenary Session 1
Shailendra Singh

Keywords

liver transplant

biliary stricture

endoscopic procedure

choledochoduodenostomy

endosonography