Endoscopic ultrasound-guided portal vein coiling: troubleshooting interventional endoscopic ultrasonography
Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS) is widely performed not only as an alternative to transpapillary biliary drainage, but also as primary drainage for malignant biliary obstruction. For anatomical reasons, this technique carries an unavoidable risk of mispuncturing intrahep...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Gastrointestinal Endoscopy
2022-05-01
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| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2021-114.pdf |
| _version_ | 1827613837084327936 |
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| author | Shin Haba Kazuo Hara Nobumasa Mizuno Takamichi Kuwahara Nozomi Okuno Akira Miyano Daiki Fumihara Moaz Elshair |
| author_facet | Shin Haba Kazuo Hara Nobumasa Mizuno Takamichi Kuwahara Nozomi Okuno Akira Miyano Daiki Fumihara Moaz Elshair |
| author_sort | Shin Haba |
| collection | DOAJ |
| description | Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS) is widely performed not only as an alternative to transpapillary biliary drainage, but also as primary drainage for malignant biliary obstruction. For anatomical reasons, this technique carries an unavoidable risk of mispuncturing intrahepatic vessels. We report a technique for troubleshooting EUS-guided portal vein coiling to prevent bleeding from the intrahepatic portal vein after mispuncture during interventional EUS. EUS-HGS was planned for a 59-year-old male patient with unresectable pancreatic cancer. The dilated bile duct (lumen diameter, 2.8 mm) was punctured with a 19-gauge needle, and a guidewire was inserted. After bougie dilation, the guidewire was found to be inside the intrahepatic portal vein. Embolizing coils were placed to prevent bleeding. Embolization coils were successfully inserted under stabilization of the catheter using a double-lumen cannula with a guidewire. Following these procedures, the patient was asymptomatic. Computed tomography performed the next day revealed no complications. |
| first_indexed | 2024-03-09T08:46:19Z |
| format | Article |
| id | doaj.art-e25ec91e95aa4d59bea5a002824cb735 |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-09T08:46:19Z |
| publishDate | 2022-05-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-e25ec91e95aa4d59bea5a002824cb7352023-12-02T15:30:56ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432022-05-0155345846210.5946/ce.2021.1147597Endoscopic ultrasound-guided portal vein coiling: troubleshooting interventional endoscopic ultrasonographyShin Haba0Kazuo HaraNobumasa Mizuno1Takamichi Kuwahara2Nozomi Okuno3Akira Miyano4Daiki Fumihara5Moaz Elshair6 Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, JapanEndoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS) is widely performed not only as an alternative to transpapillary biliary drainage, but also as primary drainage for malignant biliary obstruction. For anatomical reasons, this technique carries an unavoidable risk of mispuncturing intrahepatic vessels. We report a technique for troubleshooting EUS-guided portal vein coiling to prevent bleeding from the intrahepatic portal vein after mispuncture during interventional EUS. EUS-HGS was planned for a 59-year-old male patient with unresectable pancreatic cancer. The dilated bile duct (lumen diameter, 2.8 mm) was punctured with a 19-gauge needle, and a guidewire was inserted. After bougie dilation, the guidewire was found to be inside the intrahepatic portal vein. Embolizing coils were placed to prevent bleeding. Embolization coils were successfully inserted under stabilization of the catheter using a double-lumen cannula with a guidewire. Following these procedures, the patient was asymptomatic. Computed tomography performed the next day revealed no complications.http://www.e-ce.org/upload/pdf/ce-2021-114.pdfbiliary systemendoscopic ultrasoundobstructive jaundicepancreatic ductal carcinomatherapeutic embolization |
| spellingShingle | Shin Haba Kazuo Hara Nobumasa Mizuno Takamichi Kuwahara Nozomi Okuno Akira Miyano Daiki Fumihara Moaz Elshair Endoscopic ultrasound-guided portal vein coiling: troubleshooting interventional endoscopic ultrasonography Clinical Endoscopy biliary system endoscopic ultrasound obstructive jaundice pancreatic ductal carcinoma therapeutic embolization |
| title | Endoscopic ultrasound-guided portal vein coiling: troubleshooting interventional endoscopic ultrasonography |
| title_full | Endoscopic ultrasound-guided portal vein coiling: troubleshooting interventional endoscopic ultrasonography |
| title_fullStr | Endoscopic ultrasound-guided portal vein coiling: troubleshooting interventional endoscopic ultrasonography |
| title_full_unstemmed | Endoscopic ultrasound-guided portal vein coiling: troubleshooting interventional endoscopic ultrasonography |
| title_short | Endoscopic ultrasound-guided portal vein coiling: troubleshooting interventional endoscopic ultrasonography |
| title_sort | endoscopic ultrasound guided portal vein coiling troubleshooting interventional endoscopic ultrasonography |
| topic | biliary system endoscopic ultrasound obstructive jaundice pancreatic ductal carcinoma therapeutic embolization |
| url | http://www.e-ce.org/upload/pdf/ce-2021-114.pdf |
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