Endoscopic ultrasound-guided gallbladder drainage by transduodenal lumen-apposing metal stent in a patient with roux-en-Y reconstruction

Andrea Anderloni, Alessandro Fugazza, Luca Maroni, Edoardo Troncone, Olivia Milani, Annalisa Cappello, Asma Alkandari, Alessandro Repici

Research output: Contribution to journalArticle

Abstract

Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is increasingly recognized as an effective and safe treatment option in patients with acute cholecystitis (AC) who are deemed unfit for cholecystectomy. Recent studies suggest that an endoscopic approach to biliary decompression may reduce patient discomfort and procedure-related costs compared with the standard percutaneous transhepatic GBD, while maintaining high rates of technical and clinical success. Here we present a case of a EUS-GBD in an elderly patient with AC and with altered anatomy due to a previous partial gastrectomy with Roux-en-Y reconstruction for gastric cancer. The linear array echoendoscope was carefully advanced within the afferent limb until EUS gallbladder visualization was achieved. Transmural GBD was then performed by placement of an electrocautery-enhanced lumen-apposing metal stent. If alternative treatments are precluded, EUS-GBD in patients with AC and altered anatomy is a feasible and effective therapeutic option when performed by experienced endoscopists.

Original languageEnglish
Pages (from-to)522-524
Number of pages3
JournalAnnals of Gastroenterology
Volume32
Issue number5
DOIs
Publication statusPublished - Aug 25 2019

Keywords

  • Altered anatomy
  • Endoscopic gallbladder drainage
  • Endoscopic ultrasound
  • Lumen-apposing metal stent

ASJC Scopus subject areas

  • Gastroenterology

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