Antegrade Therapy for Management of Choledocholithiasis through Endoscopic Ultrasound-Guided Hepaticogastrostomy in a Patient with Surgically Altered Gastrointestinal Anatomy
Joint Authors
Dorrell, Robert
Madigan, Katelyn
Pawa, Swati
Pawa, Rishi
Source
Case Reports in Gastrointestinal Medicine
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-11-12
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HG) is a technique used to access the biliary tree in patients with surgically altered anatomy.
Additionally, development of EUS-HG fistula permits intraductal therapy, thereby preventing patients from requiring surgery or percutaneous transhepatic biliary drainage (PTBD), thus decreasing morbidity.
This clinical vignette describes an 83-year-old man with a history of gangrenous cholecystitis requiring cholecystectomy, partial gastrectomy, and Roux-en-Y gastrojejunostomy who presented to an outside hospital with abdominal pain and fever and found to have cholangitis and choledocholithiasis.
He underwent two endoscopic retrograde cholangiopancreatography (ERCP) procedures at an outside hospital which were unsuccessful due to an inaccessible major papilla in the setting of the patient’s surgically altered anatomy.
On arrival to Wake Forest, the patient underwent EUS-HG with successful biliary drainage and resolution of cholangitis.
He returned for ERCP three months later with balloon sphincteroplasty, cholangioscopy, and electrohydraulic lithotripsy (EHL) performed through the existing metal stent (hepaticogastrostomy), resulting in stone fragmentation and antegrade removal with balloon sweeps.
Repeat cholangioscopy post-EHL and balloon sweeps showed complete duct clearance with no residual stones.
The hepaticogastrostomy stent was subsequently removed, and the patient recovered without any complications.
American Psychological Association (APA)
Dorrell, Robert& Madigan, Katelyn& Pawa, Swati& Pawa, Rishi. 2020. Antegrade Therapy for Management of Choledocholithiasis through Endoscopic Ultrasound-Guided Hepaticogastrostomy in a Patient with Surgically Altered Gastrointestinal Anatomy. Case Reports in Gastrointestinal Medicine،Vol. 2020, no. 2020, pp.1-5.
https://search.emarefa.net/detail/BIM-1147533
Modern Language Association (MLA)
Dorrell, Robert…[et al.]. Antegrade Therapy for Management of Choledocholithiasis through Endoscopic Ultrasound-Guided Hepaticogastrostomy in a Patient with Surgically Altered Gastrointestinal Anatomy. Case Reports in Gastrointestinal Medicine No. 2020 (2020), pp.1-5.
https://search.emarefa.net/detail/BIM-1147533
American Medical Association (AMA)
Dorrell, Robert& Madigan, Katelyn& Pawa, Swati& Pawa, Rishi. Antegrade Therapy for Management of Choledocholithiasis through Endoscopic Ultrasound-Guided Hepaticogastrostomy in a Patient with Surgically Altered Gastrointestinal Anatomy. Case Reports in Gastrointestinal Medicine. 2020. Vol. 2020, no. 2020, pp.1-5.
https://search.emarefa.net/detail/BIM-1147533
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1147533