Ecoendoscopy guided hepaticogastrostomy for management of hepatolithiasis and anastomotic stricture after Roux en Y hepaticojejunostomy
DOI:
https://doi.org/10.47892/rgp.2025.451.1756Keywords:
Endosonography, Cholestasis, Intrahepatic, Cholangiopancreatography, Endoscopic RetrogradeAbstract
Endoscopic ultrasound-guided anterograde cholangiopancreatography (EUS-guided
APC) allow us to address pathologies of the bile duct that are not treatable by endoscopic
retrograde cholangiography (ERCP), such as: post-surgical benign strictures in altered
anatomy, hepatolithiasis, gastric outlet obstruction, among others. Previously, when ERCP
was not effective, surgical interventions such as Hepaticojejunostomy (HJ) or percutaneous
transperietohepatic drainage (PTHD) were resorted to. However, EUS-guided APC has
been shown to have greater clinical success, be less invasive and have a lower incidence
of complications. We present the case of a 61-years-old patient with a history of HJ bypass
surgery who presented abdominal pain due to hepatholitiasis and post-anastomosis benign
biliary stricture, in whom the antegrade technique was performed by endoscopic ultrasound
through the proximal stomach, called hepaticogastrostomy (HG) with good results.
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Copyright (c) 2025 Oscar Ponce de Leon Molina, Juan Antonio Chirinos Vega
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Revista de Gastroenterología del Perú by Sociedad Peruana de Gastroenterología del Perú is licensed under a Licencia Creative Commons Atribución 4.0 Internacional..
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