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Journals / Düzce Tıp Fakültesi Dergisi / 2026 / Volume: 25 Issue: 1

Unpredictable Event during EUS-Guided Hepaticojejunostomy

EUS Kılavuzluğundaki Hepatikojejunostomi Sırasında Öngörülemeyen Olay

Abdullatif Sirin(DÜZCE ATATÜRK DEVLET HASTANESİ)0000-0002-4001-9887
Mehmet Çetin(DUZCE UNIVERSITY, FACULTY OF MEDICINE)0000-0002-9418-7288
Salih Tokmak(DUZCE UNIVERSITY, FACULTY OF MEDICINE)0000-0002-2727-5632
Pages
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Publication Date
2023-04-30
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

We reached into the bile duct again and placed a double-pigtail plastic stent successfully.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Endoscopic ultrasound (EUS)-guided biliary drainage is a therapeutic alternative method in patients with cholestasis where the ampulla of Vater cannot be reached because several reasons.
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Key Findings & Data:A 53-year-old male patient presented with jaundice and pruritus.
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Conclusion & Impact:We reached into the bile duct again and placed a double-pigtail plastic stent successfully.
🔬Design:Case Report
📍Scope:Comprehensive Sample
⚙️Variables:Cholestasis · Extrahepatik Cholestasis · Endoscopic Ultrasound (EUS)

Abstract

Endoscopic ultrasound (EUS)-guided biliary drainage is a therapeutic alternative method in patients with cholestasis where the ampulla of Vater cannot be reached because several reasons. An unfortunate complication during EUS-guided biliary drainage was presented in this report. A 53-year-old male patient presented with jaundice and pruritus. He had a history of total gastrectomy due to gastric cancer. An abdominal tomography scan detected a tumoral mass in the common bile duct due to the recurrence of gastric cancer. We decided to perform EUS-guided hepaticojejunostomy because biliary drainage cannot be obtained by conventional methods and percutaneous drainage impairs patient comfort. A double pigtail plastic stent was placed from the jejunum into the segment-3 bile duct towards the hilus. After that echoduodenoscope was removed to the outside gently. We noticed that the stent was stuck in the echoduedonoscope elevator. We reached into the bile duct again and placed a double-pigtail plastic stent successfully.

Özet

Kolestazı olan hastalarda ampulla Vateri’ye çeşitli nedenlerde erişilemediği durumlarda endoskopik ultrason (EUS) kılavuzluğunda biliyer drenaj alternatif bir terapötik yöntemdir. Bu raporda, EUS kılavuzluğunda biliyer drenaj sırasında talihsiz bir komplikasyonun bildirilmektedir. 53 yaşında erkek hasta sarılık ve kaşıntı şikayeti ile başvurdu. Mide kanseri nedeniyle total gastrektomi öyküsü mevcuttu. Abdomen tomografisinde mide kanseri nüksüne bağlı gelişen peritoneal karsinamoza bağlı koledokta tümöral kitle saptandı. Biliyer drenajın konvansiyonel yöntemlerle sağlanamaması ve perkütan drenajın hasta konforunu bozması nedeniyle EUS eşliğinde hepatikojejunostomi yapılmasına karar verildi. Jejunumdan segment-3 safra yoluna hilusa uzanacak şekilde double pigtail plastik stent yerleştirildi. Ardından ekoduedonoskop yavaşça dışarıya çıkarıldı. Stentin ekoduedonoskopun kaldıracına takıldığı fark edildi. Safra kanalına tekrar ulaşıldı ve bir double-pigtail plastik stent başarıyla yerleştirildi.

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Cite This Article

Sirin, A., Çetin, M., Tokmak, S. (2023). Unpredictable Event during EUS-Guided Hepaticojejunostomy. Düzce Tıp Fakültesi Dergisi, Volume: 25 Issue: 1. https://doi.org/10.18678/dtfd.1207166

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