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- W2609092953 abstract "RYGB is associated with gallstone disease. RYGB makes ERCP labor-intensive and prone to failure, even despite enteroscopy assistance. ERCP in RYGB usually requires percutaneous approaches (through laparoscopy, laparotomy or interventional gastrostomy). We present a novel, modified EUS-guided approach to facilitate ERCP after RYGB. Description: 66 year old female with prior cholecystectomy and RYGB presenting with cholangitis and documented common bile duct stone. She was offered and consented to an experimental EUS-guided approach to facilitate ERCP. From the proximal stomach the excluded gastric antrum is located and punctured under EUS with a 19G needle. Saline and contrast is injected through the needle to distend the antrum and provide fluoroscopic guidance. A guidewire is coiled in the antrum. The puncture tract is sequentially dilated with a 6F cystotome and a 4-mm balloon prior to through-the-scope insertion of an enteral cSEMS 22 x 90-mm. The cSEMS is deployed across the gastric wall under combined EUS and fluroscopy and then balloon expanded over. After allowing the fistula to mature for 5 days, ERCP is performed with a standard adult duodenoscope through the gastro-gastric cSEMS. Sphincterotomy and common bile duct stone removal are performed. The duodenoscope is removed through the cSEMS, which is then exchanged in the same session for double pig-tail stent. There were no complications. The pig-tail stent was removed electively at three months without difficulty." @default.
- W2609092953 created "2017-05-05" @default.
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- W2609092953 date "2017-05-01" @default.
- W2609092953 modified "2023-09-25" @default.
- W2609092953 title "1051 Eus-Guided Transgastric Placement of Temporary Enteral Covered Self-Expandable Metal Stent (CSEMS) to Perform Through-The-Stent Ercp in Roux-En-Y-Gastric Bypass (RYGB)" @default.
- W2609092953 doi "https://doi.org/10.1016/j.gie.2017.03.223" @default.
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