What You Need to Know Before Performing Endoscopic Ultrasound-guided Hepaticogastrostomy
Clinical Endoscopy
;
: 301-308, 2021.
Article
in English
| WPRIM
| ID: wpr-890066
ABSTRACT
Endoscopic retrograde cholangiopancreatography (ERCP) is the primary treatment modality for bile duct obstruction. When ERCP is unsuccessful, percutaneous transhepatic biliary drainage can be an alternative method. Endoscopic ultrasound-guided biliary drainage (EUS-BD) has emerged as a treatment option for biliary obstruction, especially after ERCP failure. EUS-BD offers transluminal intrahepatic and extrahepatic drainage through a transgastric and transduodenal approach. EUS-guided hepaticogastrostomy (EUS-HGS) is an excellent choice for patients with hilar strictures or those with a surgically altered anatomy. The optimal steps in EUS-HGS are case selection, bile duct visualization, puncture-site selection, wire insertion and manipulation, tract dilation, and stent placement. Caution should be taken at each step to prevent complications. Dedicated devices for EUS-HGS have been developed to improve the technical success rate and reduce complications. This technical review focuses on the essential practical points at each step of EUS-HGS.
Full text:
Available
Index:
WPRIM (Western Pacific)
Language:
English
Journal:
Clinical Endoscopy
Year:
2021
Type:
Article
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