Volume 3, Issue 9, Pages (September 2018)

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Presentation transcript:

Volume 3, Issue 9, Pages 262-263 (September 2018) EUS-directed transgastric ERCP (EDGE) with use of a 20-mm × 10-mm lumen- apposing metal stent in a patient with Roux-en-Y gastric bypass Hiren Vallabh, MD VideoGIE Volume 3, Issue 9, Pages 262-263 (September 2018) DOI: 10.1016/j.vgie.2018.06.005 Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 A, MRCP showing marked intrahepatic and extrahepatic biliary ductal dilation with abrupt cutoff of the mid common bile duct. B, EUS image showing insertion of 19-gauge EUS needle into the excluded stomach. C, EUS image of contrast material and sterile water being injected through 19-gauge EUS needle to distend the excluded stomach. D, EUS image of 20-mm × 10-mm electrocautery-enhanced lumen-apposing metal stent (LAMS) inserted into the gastric remnant through the gastric pouch, creating a gastrogastric fistula. E, Endoscopic image confirming placement of the proximal flange of the LAMS within the gastric pouch. F, Ampulla visualized by duodenoscope. G, Cholangiogram demonstrating distal stricture of the common bile duct (CBD) with upstream dilation of the CBD up to 15 mm. H, Fluoroscopic image of placement of a 10F × 7-cm plastic biliary stent. VideoGIE 2018 3, 262-263DOI: (10.1016/j.vgie.2018.06.005) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions