Endoscopic ultrasound (EUS)-guided antegrade intervention for a hepaticojejunostomy anastomosis obstruction under peroral cholangioscopy via an EUS-guided hepaticogastrostomy route

Yonamine, Keisuke; Koshita, Shinsuke; Kanno, Yoshihide; Ogawa, Takahisa; Kusunose, Hiroaki; Sakai, Toshitaka; Ito, Kei

doi:10.1055/a-1810-7068

Cited by 3 publications

(3 citation statements)

References 3 publications

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“…Another described technique is the EUS-HGS dysfunction approach through direct visualization with a cholangioscope; this device allows a direct visualization of the stenosis zone and a more accurate maneuverability with the guidewire and sphincterotome 9 .…”

Section: Discussionmentioning

confidence: 99%

Successful re-intervention with antegrade insertion of the metal stent into the hepaticojejunostomy through the hepaticogastrostomy route

Romero-Flores,

Juárez-Hernández,

López-Méndez

2023

END

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Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is a therapeutic tool that allows for biliary drainage when conventional endoscopic retrograde cholangiopancreatography is technically or clinically unsuccessful. For those cases where re-intervention of HGS stent is necessary to treat obstruction, this kind of approach could be an option. We describe a novel technique to treat EUS-HGS obstruction.

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Section: Discussionmentioning

confidence: 99%

Successful re-intervention with antegrade insertion of the metal stent into the hepaticojejunostomy through the hepaticogastrostomy route

Romero-Flores,

Juárez-Hernández,

López-Méndez

2023

END

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“…EUS-guided biliary drainage consists in creating an hepaticogastrostomy between the left intra-hepatic ducts (which need to be dilated) and the stomach. A metal stent is placed and POCS lithotripsy can then be performed through the stent [27]. In gastric bypass with Roux-en-Y reconstruction patients, EUS guided gastro-gastrostomy between the stomach pouch and the excluded stomach, with lumen apposing metal stent placement, allows the advancement of a duodenoscope into the duodenum, similar to conventional ERCP.…”

Section: Indicationsmentioning

confidence: 99%

Cholangioscopy for biliary diseases

Becq

Soualy

Camus

2023

Current Opinion in Gastroenterology

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Purpose of reviewCholangioscopy is a mini-invasive endoscopic procedure, which consists in a direct intraductal visualization of the biliary tract. The purpose of this review is to summarize the technique, the clinical applications, as well as future perspectives of cholangioscopy. Recent findingsNumerous technologic advances during the last decades have allowed for an improved utility and functionality, leading to a broader use of this procedure, for diagnostic or therapeutic purposes, in the setting of biliary diseases. Novel tools and emerging indications have been developed and more are yet to come. SummaryCholangioscopy can be performed by peroral, percutaneous transhepatic or intra-operative transcystic or transcholedochal access. Clinical applications of cholangioscopy are multiple, ranging from visual impression and optical guided biopsies of indeterminate biliary strictures to the management of difficult stones , guidance before biliary stenting and retrieval of migrated ductal stents. Multiple devices such as lithotripsy probes, biopsy forceps, snares and baskets have been developed to help achieve these procedures successfully. Cholangioscopy has improved the way biliary diseases can be visualized and treated. New technology, accessories, and applications are expected in the future.

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“…Patients with hepaticojejunal anastomosis strictures or huge intrahepatic stones may require multiple endoscopic interventions. The application of POC through the HGS route has been described in various case reports and it was effective in performing lithotripsy and stone removal [ 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 ] and for the treatment of anastomotic strictures [ 127 , 128 , 129 ]. POC through HGS also allowed for the removal of migrated biliary stents in two case reports [ 130 , 131 ].…”

Section: Cholangioscopy Through Different Routesmentioning

confidence: 99%

The Role of Cholangioscopy in Biliary Diseases

Mauro,

Mazza,

Scalvini

et al. 2023

Diagnostics

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Endoscopy plays a central role in diagnostic and therapeutic approaches to biliary disease in both benign and malignant conditions. A cholangioscope is an endoscopic instrument that allows for the direct exploration of the biliary tree. Over the years, technology has improved endoscopic image quality and allowed for the development of an operative procedure that can be performed during cholangioscopy. Different types of instruments are available in this context, and they can be used in different anatomical access points according to the most appropriate clinical indication. The direct visualization of biliary mucosa is essential in the presence of biliary strictures of unknown significance, allowing for the appropriate allocation of patients to surgery or conservative treatments. Cholangioscopy has demonstrated excellent performance in discriminating malignant conditions (such as colangiocarcinoma) from benign inflammatory strictures, and more recent advances (e.g., artificial intelligence and confocal laser endomicroscopy) could further increase its diagnostic accuracy. Cholangioscopy also plays a primary role in the treatment of benign conditions such as difficult bile stones (DBSs). In this case, it may not be possible to achieve complete biliary drainage using standard ERCP. Therapeutic cholangioscopy-guided lithotripsy allows for stone fragmentation and complete biliary drainage. Indeed, other complex clinical situations, such as patients with intra-hepatic lithiasis and patients with an altered anatomy, could benefit from the therapeutic role of cholangioscopy. The aim of the present review is to explore the most recent diagnostic and therapeutic advances in the roles of cholangioscopy in the management of biliary diseases.

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Endoscopic ultrasound (EUS)-guided antegrade intervention for a hepaticojejunostomy anastomosis obstruction under peroral cholangioscopy via an EUS-guided hepaticogastrostomy route

Cited by 3 publications

References 3 publications

Successful re-intervention with antegrade insertion of the metal stent into the hepaticojejunostomy through the hepaticogastrostomy route

Successful re-intervention with antegrade insertion of the metal stent into the hepaticojejunostomy through the hepaticogastrostomy route

Cholangioscopy for biliary diseases

The Role of Cholangioscopy in Biliary Diseases

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