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Case Reports
. 2024 Aug 23;11(8):e01469.
doi: 10.14309/crj.0000000000001469. eCollection 2024 Aug.

Single-Session Endoscopic Ultrasound-Directed Transgastric Endoscopic Retrograde Cholangiopancreatography and Simultaneous Endoscopic Ultrasound-Guided Transmural Gallbladder Drainage in Choledocholithiasis and Acute Cholecystitis After Unsuccessful Laparoscopic Cholecystectomy

Azhar Hussain  1 , Vishnu Charan Suresh Kumar  2 , Hafiz Muzaffar Akbar Khan  2
Affiliations
Case Reports

Single-Session Endoscopic Ultrasound-Directed Transgastric Endoscopic Retrograde Cholangiopancreatography and Simultaneous Endoscopic Ultrasound-Guided Transmural Gallbladder Drainage in Choledocholithiasis and Acute Cholecystitis After Unsuccessful Laparoscopic Cholecystectomy

Azhar Hussain et al. ACG Case Rep J. .

Abstract

In patients considered high risk of laparoscopic cholecystectomy, percutaneous gallbladder drainage is traditionally considered first-line treatment option. Recent evidence supports endoscopic gallbladder drainage as a safe and feasible alternate option. We describe a case of Roux-en-Y gastric bypass surgery patient with acute cholecystitis and choledocholithiasis with unsuccessful laparoscopic cholecystectomy because of difficult operative field, underwent successful single-session endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography and endoscopic ultrasound-guided transmural gallbladder drainage at our institution.

Keywords: EUS-guided gallbladder drainge; SS-EDGE; acute cholecystitis.

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Figures

Figure 1.
Figure 1.
(A) Endoscopic image of successful deployment of lumen-apposing metal stent into excluded stomach confirmed by free flow of methylene blue and saline. (B) Endoscopic image of lumen-apposing metal stent anchored with X-Tack revealing distal CBD stone and dilated CBD during SS-EDGE. (C) Fluoroscopic image of lumen-apposing metal stent anchored with X-Tack revealing distal CBD stone and dilated CBD during SS-EDGE. (D) Fluoroscopic image of lumen-apposing metal stent placed for endoscopic ultrasound–guided cholecystoenterostomy with 10-Fr-by-3-cm plastic biliary stent with a full external pigtail and a full internal pigtail placed into the gallbladder. (E) Endoscopic view of gastrogastrostomy site after lumen-apposing metal stent and X-Tack removal and argon plasma coagulation before closing fistula. (F) Endoscopic closure of gastrogastric fistula using overstitch device. (G) Endoscopic view of closed gastrogastric fistula using 2.0 polypropylene suture. CBD, common bile duct; SS-EDGE, single-session endoscopic ultrasound–directed transgastric endoscopic retrograde cholangiopancreatography.
See this image and copyright information in PMC

References

    1. Angrisani L, Santonicola A, Iovino P, et al. IFSO worldwide survey 2016: Primary, endoluminal, and revisional procedures. Obes Surg. 2018;28(12):3783–94. - PubMed
    1. Tustumi F, Pinheiro Filho JEL, Stolzemburg LCP, et al. Management of biliary stones in bariatric surgery. Ther Adv Gastrointest Endosc. 2022;15:26317745221105087. - PMC - PubMed
    1. Rerknimitr R, Pham KC. Practical approaches for high-risk surgical patients with acute cholecystitis: The percutaneous approach versus endoscopic alternatives. Clin Endosc. 2020;53(6):678–85. - PMC - PubMed
    1. Itoi T, Itokawa F, Sofuni A, et al. Evaluation of 19-gauge endoscopic ultrasonography aspiration needles using various echoendoscopes. Endosc Int Open 2013;1(1):24–30. - PMC - PubMed
    1. Kadkhodayan KS, Hussain A, Arain MA, Yang D, Hasan MK. Helix tack for lumen-apposing metal stent fixation in single-session EUS-directed transgastric ERCP. VideoGIE. 2023;8(4):151–4. - PMC - PubMed

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