Publication: What you need to know before performing endoscopic ultrasound-guided hepaticogastrostomy
Issued Date
2021-05-01
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ISSN
22342443
22342400
22342400
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2-s2.0-85107374085
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Mahidol University
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SCOPUS
Bibliographic Citation
Clinical Endoscopy. Vol.54, No.3 (2021), 301-308
Suggested Citation
Tanyaporn Chantarojanasiri, Thawee Ratanachu-Ek, Nonthalee Pausawasdi What you need to know before performing endoscopic ultrasound-guided hepaticogastrostomy. Clinical Endoscopy. Vol.54, No.3 (2021), 301-308. doi:10.5946/ce.2021.103 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78212
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Title
What you need to know before performing endoscopic ultrasound-guided hepaticogastrostomy
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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.