Endoscopic gallbladder drainage in high-risk surgical patients

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Presentation transcript:

Endoscopic gallbladder drainage in high-risk surgical patients Alejandro L. Suarez, MD, Song Mingjun, MD, Thiruvengadam Muniraj, MD, Priya Jamidar, MD, Harry Aslanian, MD VideoGIE Volume 3, Issue 11, Pages 364-367 (November 2018) DOI: 10.1016/j.vgie.2018.08.016 Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 Fluoroscopic image revealing a normal balloon occlusion cholangiogram without visualization of cystic duct. VideoGIE 2018 3, 364-367DOI: (10.1016/j.vgie.2018.08.016) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 Direct visualization of cystic duct origin (arrow) deep to main bile duct during cholangioscopy. VideoGIE 2018 3, 364-367DOI: (10.1016/j.vgie.2018.08.016) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 Successful fluoroscopic placement of transpapillary double-pigtail plastic stent. VideoGIE 2018 3, 364-367DOI: (10.1016/j.vgie.2018.08.016) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 4 EUS view of the stomach revealing an enlarged gallbladder containing sludge without intervening vessels. VideoGIE 2018 3, 364-367DOI: (10.1016/j.vgie.2018.08.016) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 5 Successful deployment of lumen-apposing metal stent external flange in prepyloric region draining bile. VideoGIE 2018 3, 364-367DOI: (10.1016/j.vgie.2018.08.016) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 6 Partially buried external flange of previously placed lumen-apposing metal stent and double-pigtail stent buried within the prepyloric region of the stomach wall containing clotted blood and debris. VideoGIE 2018 3, 364-367DOI: (10.1016/j.vgie.2018.08.016) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 7 After endoscopic removal of partially buried stent, antegrade cholangiographic view demonstrating a mature intact cholecystogastrostomy without extravasation of contrast material. VideoGIE 2018 3, 364-367DOI: (10.1016/j.vgie.2018.08.016) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 8 Replacement of 2 longer double-pigtail plastic stents within mature cholecystogastrostomy to maintain patency and relieve apposing gallbladder and stomach wall tension. VideoGIE 2018 3, 364-367DOI: (10.1016/j.vgie.2018.08.016) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions