EUS-guided hepaticogastrostomy with a lumen apposing metal stent used in the management of a malignant hilar stricture

Abstract Text A 58-year-old female presented with jaundice due to metastatic cholangiocarcinoma. After a failed ERCP, EUS-guided hepaticogastrostomy using LAMS was attempted. LAMS catheter did not penetrate the gastric wall due to connecting to an improper cable. This resulted in bleeding from scratching the gastric wall with the tip of the ”cold” delivery catheter. LAMS was connected to the proper cable and a hepaticogastrostomy (LAMS 15 x 15mm) was achieved. Angiogram revealed extravasation from a branch of the left gastric artery which was embolized. The resultant blood clot occluded LAMS requiring a temporary PTC. Three weeks later, the patency of LAMS was confirmed. PTC was removed and two uncovered metal stents were deployed to the right side after endobiliary RFA.

Video http://data.process.y-congress.com/ScientificProcess/Data//106/474/1197/9c1ee6d9-f2c1-48ba-84f8-421e127dbf49/Uploads/13821_HG_axios%20B.mp4

Conflicts of interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
15 April 2024