title: Endoscopic ultrasonography-guided transhepatic antegrade stone removal in patients with surgically altered anatomy: case series and technical review (with videos).
abstract: Recently, endoscopic ultrasonography (EUS)-guided transhepatic antegrade interventions have been introduced in patients with a surgically altered anatomy. Herein, we focused on and reviewed EUS-guided transhepatic antegrade stone removal (EUS-TASR) in patients with a surgically altered anatomy and native papilla. The basic technique of EUS-TASR involves the following steps: (1) EUS-guided needle puncture; (2) guidewire placement; (3) tract dilation; (4) balloon sphincteroplasty; (5) stone removal; and (6) stent placement if needed. Based on reports in the literature including our cases, the complete stone extraction rate is 71.4% (10/14) including five of our cases (60% success rate) at one session without serious complications. In conclusion, EUS-TASR appears to be feasible and useful in selected patients although its application may be limited depending on anatomical factors and current devices used.
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. itoi@tokyo-med.ac.jp.
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sofuni
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: Masashi
authors.initials: M
authors.lastname: Ijima
authors.forename: Takuji
authors.initials: T
authors.lastname: Iwashita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D004322:Drainage / Q000379:methods; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D009339:Needles; D011677:Punctures; D012086:Reoperation; D016717:Sphincterotomy, Endoscopic; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
keywords: Bile duct stone; Endoscopic papillary balloon dilation; Endoscopic ultrasonography; Endoscopic ultrasonography-guided biliary drainage