ASGE Therapeutic EUS for Advanced Endosonographers (On-Demand) | September 2022-EUS-Guided Gastrojejunostomy and Gallbladder Drainage

Video Transcription

Video Summary

In this video, the speaker discusses two interventional endoscopic procedures: EUS gastroenterostomy and EUS gallbladder drainage. The speaker begins by expressing gratitude for the opportunity to speak and emphasizing the importance of these procedures in opening doors and windows to new possibilities in endoscopy. EUS gastroenterostomy is discussed first, with the speaker explaining that it is used to circumvent the limitations of stenting for malignant gastric outlet obstruction. The efficacy of EUS gastroenterostomy is supported by multiple series, with technical and clinical success ranging from 80% to over 90%. However, the speaker warns that adverse events are higher compared to other procedures and should be anticipated and planned for accordingly. The speaker then explains the steps involved in EUS gastroenterostomy, including identifying and confirming the target, distending or stabilizing the target, accessing the target, and placing the stent. The speaker also emphasizes the importance of planning for adverse events and ensuring that the necessary equipment and personnel are available. The speaker then discusses EUS gallbladder drainage, explaining that it is indicated for high-risk patients who are not candidates for surgical cholecystectomy. The speaker explains the technique for EUS gallbladder drainage, including puncturing the gallbladder and placing a stent. The speaker compares EUS gallbladder drainage to percutaneous cholecystostomy and ERCP-guided transpapillary cystic and gallbladder stenting, highlighting the advantages and disadvantages of each approach. The speaker concludes by reminding the audience that EUS-guided interventional endoscopy requires high technical skills, and decisions regarding the choice of procedure should be tailored to the individual patient.

Asset Subtitle

Mihir Wagh, MD, FASGE

Keywords

interventional endoscopic procedures

EUS gastroenterostomy

EUS gallbladder drainage

limitations of stenting

adverse events

high-risk patients

surgical cholecystectomy

EUS-guided interventional endoscopy