Preoperative decompression and diagnosis of pancreatic head adenocarcinoma in a patient with Roux-en-Y gastric bypass by means of EUS-guided gastric pouch.

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Presentation transcript:

Preoperative decompression and diagnosis of pancreatic head adenocarcinoma in a patient with Roux-en-Y gastric bypass by means of EUS-guided gastric pouch hepaticogastrostomy Mohamed M. Abdelfatah, MD VideoGIE Volume 2, Issue 6, Pages 143-144 (June 2017) DOI: 10.1016/j.vgie.2017.03.002 Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 A, EUS image with the endoscope positioned in the gastric pouch shows dilated intrahepatic bile ducts (arrow). B, Endoscopic view of the proximal end of the hepaticogastrostomy stent from within the gastric pouch. C, Fluoroscopic image shows cytology brush positioned across the distal CBD stricture (yellow arrow) as it was passed antegrade via the HG stent (red arrows). D, Post-drainage, preoperative CT scan shows the HG stent in a good position (red arrows) and a resectable mass in the pancreatic head (white arrow). E, Fluoroscopic view of the HG stent 10 weeks after the Whipple procedure. F, Cholangiographic image obtained at the time of HG stent removal shows a patent choledochojejunostomy. CBD, common bile duct; HG, hepaticogastrostomy. VideoGIE 2017 2, 143-144DOI: (10.1016/j.vgie.2017.03.002) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions