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Endoscopic Ultrasound Guided Hepatico – Gastrostomy

Endoscopic Ultrasound Guided Hepatico - Gastrostomy

Background

A 50 year old man presented with jaundice a year after undergoing Whipple’s surgery for pancreatic head malignancy. There was a recurrent lesion causing Hepatico-jejunostomy site narrowing.

Diagnosis And Treatment

EUS guided puncture of IHBRD in the second segment of liver was done from stomach and after the cholangiogram, the tract was dilated sequentially using cystotomes till 10F and a 60x10 mm fully covered biliary metal stent was deployed connecting the stomach and the second segment of liver. A 7F 7cm double pigtail plastic stent was deployed within the metal stent to prevent its displacement. There were no periprocedural complications and the patient underwent chemotherapy after normalization of bilirubin. During follow-up 3 months after the procedure, the patient’s LFT remained normal.

Endoscopic Ultrasound Guided Hepatico - Gastrostomy

EUS guided puncture ofIHBRD from stomach

Endoscopic Ultrasound Guided Hepatico - Gastrostomy

Cholangiogram

 

Endoscopic Ultrasound Guided Hepatico - Gastrostomy

Dilatation of tract withcystotomes

Endoscopic Ultrasound Guided Hepatico - Gastrostomy

FCSEMS placemen

Endoscopic Ultrasound Guided Hepatico - Gastrostomy

FCSEMS with aplastic stent within

About Author –

Dr. A. Bharath Kumar, Consultant Interventional Gastroenterologist and Hepatologist, Yashoda Hospital, Hyderabad
MD, DM (Gastroenterology)

best Gastroenterologist in hyderabad

Dr. A. Bharath Kumar

MD, DM (Gastroenterology)
Consultant Interventional Gastroenterologist and Hepatologist

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