ASGE Endoscopy Live: Interventional EUS and Endo-Hepatology (On-Demand) | July 2023-7-13-23 Endoscopy Live Case Demonstration 3

7-13-23 Endoscopy Live Case Demonstration 3 - Orlando Health

Video Transcription

Video Summary

In this video, Dr. Shyam Varadarajulu demonstrates a QUS-guided biliary drainage or gallbladder drainage procedure on a 56-year-old patient with malignant obstructive jaundice. The patient had already undergone an ERCP procedure, but further treatment was needed to reduce bilirubin levels. Using EUS and fluoroscopy, Dr. Varadarajulu attempts to navigate a wire into the liver hilum to create a pathway for drainage. However, due to the challenging anatomy, the wire cannot be advanced as desired. Dr. Varadarajulu decides to repuncture the liver and deploy a stent on the gastric side to drain bile. The procedure is completed using endoscopic view to ensure the stent is properly positioned in the stomach. Dr. Varadarajulu explains that placing plastic stents would not be effective in this case, as there is no viable duct to support them. Despite the challenges, the procedure is expected to provide palliation for the patient's symptoms.

Asset Subtitle

EUS-guided gallbladder drainage
Shyam Varadarajulu, MD

Keywords

QUS-guided biliary drainage

malignant obstructive jaundice

ERCP procedure

wire navigation

stent deployment

symptom palliation