Utilization of a Small-Caliber Balloon Dilator for Endoscopic Ultrasound-Guided Hepaticogastrostomy Creation: Case Series

The standard management for obstructive jaundice related to benign or malignant biliary strictures is endoscopic retrograde cholangiopancreatography (ERCP). 1 Standards of Practice Committee ASGE Chathadi KV Chandrasekhara V et al. The role of ERCP in benign diseases of the biliary tract. Gastrointest Endosc. 2015; 81: 795-803https://doi.org/10.1016/j.gie.2014.11.019 Abstract Full Text Full Text PDF Scopus (93) Google Scholar ,2 Qumseya BJ Jamil LH Elmunzer BJ et al. ASGE guideline on the role of endoscopy in the management of malignant hilar obstruction. Gastrointest Endosc. 2021; 94 (e22): 222-234https://doi.org/10.1016/j.gie.2020.12.035 Abstract Full Text Full Text PDF Scopus (21) Google Scholar However, ERCP can be difficult or impossible in cases of obstruction or surgically altered anatomy (SAA). In such cases, the historical treatment of choice has been percutaneous transhepatic biliary drainage (PTBD), which has a high rate of technical and clinical success but is associated with increased adverse events (AEs). 3 Oh HC Lee SK Lee TY et al. Analysis of percutaneous transhepatic cholangioscopy-related complications and the risk factors for those complications. Endoscopy. 2007; 39: 731-736https://doi.org/10.1055/s-2007-966577 Crossref PubMed Scopus (123) Google Scholar ,4 Weber A Gaa J Rosca B et al. Complications of percutaneous transhepatic biliary drainage in patients with dilated and nondilated intrahepatic bile ducts. Eur J Radiol. 2009; 72: 412-417https://doi.org/10.1016/j.ejrad.2008.08.012 Abstract Full Text Full Text PDF PubMed Scopus (107) Google Scholar