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 Transcription

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

Meta Tag

Concept Biliary Stricture

Concept Benign Colorectal Anastomotic Stricture

Concept Roux-en-Y Anatomy

Concept Endoscopic Ultrasound

Concept Lumen-Apposing Metal Stent

Keywords

liver transplant

biliary stricture

endoscopic procedure

choledochoduodenostomy

endosonography

Biliary Stricture

Benign Colorectal Anastomotic Stricture

Roux-en-Y Anatomy

Endoscopic Ultrasound

Lumen-Apposing Metal Stent