EUS-EUS GUIDED HEPATICOGASTROSTOMY FOR MANAGEMENT OF CHOLANGITIS, HEPATOLITHIASIS AND ANASTOMOTIC STRICTURE AFTER ROUX-EN-Y HEPATICOJEJUNOSTOMY

EUS GUIDED HEPATICOGASTROSTOMY FOR MANAGEMENT OF CHOLANGITIS, HEPATOLITHIASIS AND ANASTOMOTIC STRICTURE AFTER ROUX-EN-Y HEPATICOJEJUNOSTOMY

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Video Transcription

Video Summary

In this video, an endoscopic ultrasound-guided hepaticogastrostomy (EUS-HG) procedure is performed on a 43-year-old female with obstructive jaundice and cholangitis. The patient had a prior laparoscopic cholecystectomy complicated by bile duct injury and Roux-en-Y hepaticogenostomy. The procedure involves accessing the biliary tree through the stomach and using a 19-gauge FNA needle to puncture the biliary radical. Stones are identified in the left hepatic duct, along with an anastomotic stricture. A fully covered metal stent is placed across the hepaticogastrostomy tract, and the patient is discharged without complications. The patient will undergo further procedures for the management of intrapathic stones and the anastomotic stricture. EUS-HG is shown to be a safe alternative to surgery and PTBD in patients with altered GI anatomy.

Asset Subtitle

Honorable Mention

Keywords

endoscopic ultrasound-guided hepaticogastrostomy

obstructive jaundice

cholangitis

laparoscopic cholecystectomy

bile duct injury