Transgastric biliary brushing: a novel endoscopic technique

A 71-year-old woman with pancreatic adenocarcinoma status post-Whipple presented with obstructive jaundice due to suspected tumor recurrence. Single-balloon enteroscopy was unable to reach the hepaticojejunostomy. EUS with FNA was not feasible due to altered anatomy. The echoendoscope was advanced into the stomach, and the left intrahepatic duct was accessed. A cholangiogram revealed biliary dilation proximal to an anastomotic stricture. A guidewire was advanced into the left biliary system, but could not be advanced across the anastomosis into the jejunum.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: VideoGIE Source Type: research