Altered anatomy: An EUS-guided placement of a lumen-apposing metal stent for successful ERCP following Whipple procedure (with video)

Abstract:

Increased prevalence of surgically altered anatomy in patients with biliary obstruction presents a technical challenge to endoscopists. Novel approaches employing EUS in altered postsurgical anatomy have been described but are limited.[1] This is a case of a EUS-guided lumen-apposing metal stent (LAMS) placement for successful ERCP in a patient with recurrent cholangitis following pancreaticoduodenectomy. The patient is a 75-year-old woman with a history of intraductal papillary mucinous neoplasms treated with Whipple pancreaticoduodenectomy complicated by strictures and recurrent cholangitis. Prior ERCPs were unsuccessful since the standard duodenoscope was too short to access the biliary anastomosis in the altered anatomy. We placed a EUS-guided gastrojejunal LAMS to create a direct passageway from the stomach into the afferent limb for future ERCPs [Video 1]. First, we advanced a balloon …

Año de publicación:

2022

Keywords:

Fuente:

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