Fluoroscopic-Assisted, EUS-Guided Trans-Sigmoidal Pancreas Biopsy in a Patient with Surgically Altered Anatomy

AbstractOne of the main challenges encountered by endosonographers is performing diagnostic and interventional pancreato-biliary endoscopic ultrasound (EUS) procedures in the presence of surgically altered upper gastrointestinal anatomy. We describe the water-filled technique (WFT) for EUS examination and treatment of the pancreato-biliary region in patients with surgically altered upper gastrointestinal anatomy. Using the WFT, the scope is advanced up to the gastro-jejunal anastomosis and, after placing the tip of the scope 2 cm beyond it, enlargement of the jejunal lumen is obtained by water instillation of the jejunal loop. An enlargement of more than 1.5 cm allows advancement of the tip of the scope under EUSguidance up to the duodenum, in a retrograde way. The WFT is useful for reaching the ampullary area and performing diagnostic and therapeutic EUS in patients with surgically altered anatomy. The technique is also reproducible and can be easily used by endoscopists who regularly perform EUS.

Download Full-text

Successful endoscopic papillectomy with intrapancreatic ductal radiofrequency ablation for ampulla cancer in surgically altered anatomy

Endoscopy ◽

10.1055/a-1388-5717 ◽

2021 ◽

Author(s):

Jung Su Lee ◽

Hoonsub So ◽

Jun Seong Hwang ◽

Sung Woo Ko ◽

Tae Jun Song

Keyword(s):

Radiofrequency Ablation ◽

Surgically Altered Anatomy ◽

Endoscopic Papillectomy

Download Full-text

Sp696 Switching it up. EUS-Guided Antegrade Clearance of Biliary Stones in “Duodenal Switch” Surgically Altered Anatomy

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2011.03.1214 ◽

2011 ◽

Vol 73 (4) ◽

pp. AB102

Author(s):

Stavros N. Stavropoulos ◽

Teodor C. Pitea ◽

Jessica L. Widmer ◽

Michael D. Harris ◽

Michael E. Khalife ◽

...

Keyword(s):

Duodenal Switch ◽

Biliary Stones ◽

Surgically Altered Anatomy

Download Full-text

ID: 3521057 EFFICACY AND SAFETY OF DOUBLE-BALLOON ENDOSCOPY-ASSISTED ENDOSCOPIC PAPILLARY LARGE BALLOON DILATION FOR COMMON BILE DUCT STONE REMOVAL IN PATIENTS WITH SURGICALLY ALTERED ANATOMY HAVING AN INTACT PAPILLA

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2021.03.974 ◽

2021 ◽

Vol 93 (6) ◽

pp. AB146-AB147

Author(s):

Takuya Ishikawa ◽

Hiroki Kawashima ◽

Eizaburo Ohno ◽

Tadashi Iida ◽

Hirotaka Suzuki ◽

...

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Common Bile Duct Stone ◽

Bile Duct Stone ◽

Balloon Dilation ◽

Efficacy And Safety ◽

Double Balloon Endoscopy ◽

Surgically Altered Anatomy ◽

Large Balloon ◽

Large Balloon Dilation

Download Full-text

Transjejunal laparoscopic-assisted ERCP in Roux-en-Y patient: the new right path

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2018.0188 ◽

2019 ◽

Vol 101 (2) ◽

pp. e45-e47 ◽

Cited By ~ 1

Author(s):

MT Mita ◽

G Dalmonte ◽

A Gnocchi ◽

F Marchesi

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gastrointestinal Tract ◽

General Population ◽

Subtotal Gastrectomy ◽

Gastric Surgery ◽

New Right ◽

Endoscopic Retrograde ◽

Biliary Lithiasis ◽

Surgically Altered Anatomy ◽

Laparoscopic Assisted

The incidence of biliary lithiasis after gastric surgery seems to be higher than in the general population. Endoscopic retrograde cholangiopancreatography (ERCP) allows several biliary and pancreatic pathologies to be dealt with; however, in patients with an altered anatomy of the upper and mid gastrointestinal tract, this endoscopic manoeuvre can be extremely challenging. We report a case of a 79-year-old woman with previous subtotal gastrectomy and Roux-en-Y reconstruction, admitted with a diagnosis of cholecystitis and choledocolithiasis. She was successfully treated with transjejunal laparoscopic-assisted ERCP and laparoscopic cholecystectomy, which appears to be a safe and useful procedure for choledocolithiasis treatment in patients with surgically altered anatomy.

Download Full-text