ASGE Endoscopy Live: Interventional EUS and Endo-Hepatology | July 2023-7-13-23 Endoscopy Live Case Demonstration 5.1

7-13-23 Endoscopy Live Case Demonstration 5.1 - Hospital Universitario Rio Hortega

Video Transcription

Video Summary

In this video, Dr. Manuel Perez Miranda demonstrates an EUS-guided gastroenterostomy procedure on an 82-year-old man with a history of obstetric jaundice and a pancreatic tumor. Dr. Miranda introduces his team, including Mar, an endoscopy tech, Maria, an endoscopy nurse, Rebecca, an x-ray tech, and fellow doctors Viridiana and Antonio. Using a technique called "dry-wet," Dr. Miranda uses a gastroscope to pass a guide wire past a duodenal stricture and into the small bowel. He then uses an 8.5 French nasobiliary drain to create an opening for the gastroenterostomy. The procedure is guided by fluoroscopy and ultrasound. Once the distal and proximal flanges of the drain are deployed, Dr. Miranda confirms the small bowel location by injecting methylene blue and seeing a boiling water sign. The procedure is successful, and Dr. Miranda mentions that this approach is favored over surgical GJ procedures for palliation of malignant gastric outlet obstruction. The video ends with Dr. Miranda offering to perform another GJ procedure if there is interest.

Asset Subtitle

EUS-guided gastroenterostomy
Endoscopist: Dr. Manuel Perez-Miranda(Hospital Universitario Rio Hortega)

Keywords

EUS-guided gastroenterostomy

obstetric jaundice

pancreatic tumor

dry-wet technique

fluoroscopy

ultrasound