ASGE DDW Videos from Around the World | 2025-TRANSHEPATIC ENDOBILIARY VASCULAR INTERVENTION (THEVI) IN A CASE OF BLEEDING HEPATICOJEJUNAL VARICES

TRANSHEPATIC ENDOBILIARY VASCULAR INTERVENTION (THEVI) IN A CASE OF BLEEDING HEPATICOJEJUNAL VARICES

Video Transcription

Video Summary

The video describes a novel two-step procedure to address bleeding hepatico-jejunal varices, a challenging complication in hepatico-jejunostomy patients. A percutaneous transhepatic biliary tract is created and dilated, allowing access for hemostasis via colidocoscopy and histoacryl glue injection into the varices. Conventional methods failed in a 54-year-old previously operated patient, prompting this innovative approach. The procedure involves initial tamponade using a balloon catheter, tract dilatation, and targeted variceal treatment. Endoscopic follow-ups showed improvement. This percutaneous method provides essential access for intervention in complex biliary anatomies but requires further research to establish safety and effectiveness.

Asset Subtitle

James Emmanuel, Thanesh Kumar, Aida S. Hamiddin, Raman Muthukaruppan

Meta Tag

Concept Hepatico-jejunal Varices

Concept Portal Cavernoma

Concept Hemostasis

Concept Roux-en-Y Hepaticojejunostomy

Concept Portal Hypertension

Keywords

hepatico-jejunal varices

percutaneous transhepatic

histoacryl glue injection

balloon catheter tamponade

biliary anatomies intervention

Hepatico-jejunal Varices

Portal Cavernoma

Hemostasis

Roux-en-Y Hepaticojejunostomy

Portal Hypertension