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CC BY 4.0 · Journal of Digestive Endoscopy 2023; 14(01): 049-050
DOI: 10.1055/s-0043-1762575
Endoscopy Video

Endoscopic Management of a Complex Biliary Problem

Mayur G. Gattani 
1   Department of Gastroenterology, Midas Multi-Speciality Hospital, Nagpur, India
,
Shrikant Mukewar
1   Department of Gastroenterology, Midas Multi-Speciality Hospital, Nagpur, India
,
Akshay Kulkarni
1   Department of Gastroenterology, Midas Multi-Speciality Hospital, Nagpur, India
,
Bhushan Bhaware
1   Department of Gastroenterology, Midas Multi-Speciality Hospital, Nagpur, India
,
Saurabh Mukewar
1   Department of Gastroenterology, Midas Multi-Speciality Hospital, Nagpur, India
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Abstract

Endoscopic interventions have become increasingly popular in the management of obstructive jaundice. In this case study, we present a case of complex Bismuth type 4 hilar stricture in an elderly lady presenting with obstructive jaundice. Complete endoscopic biliary drainage was accomplished successfully by placement of three metal stents – two with ERCP and one with Endoscopic Ultrasound (EUS) guided hepatico-gastrostomy. She developed cholecystitis later, which was successfully addressed by EUS guided gallbladder drainage using a cautery enhanced lumen apposing metal stent. Thus, a complete internal biliary drainage was achieved with endoscopic interventions.

Keywords

Obstructive jaundice - Endoscopic ultrasound - Acute cholecystitis


Publication History

Article published online:
29 March 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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