• Internal medicine · Aug 2023

    Case Reports

    Drainage of Afferent Limb Obstruction via the Trans-gastric-bile Duct Formed after Endoscopic Ultrasound-guided Hepaticogastrostomy in a Patient with Pancreatic Cancer.

    • Masatoshi Mabuchi, Seiji Adachi, Yukari Uno, Hironori Nakamura, Makoto Shimazaki, Shinji Nishiwaki, Iwao Kumazawa, Takuji Iwashita, and Masahito Shimizu.
    • Department of Gastroenterology, Ibi Kosei Hospital, Gifu-Seino Medical Center, Japan.
    • Intern. Med. 2023 Aug 15; 62 (16): 235523592355-2359.

    AbstractA 63-year-old man with advanced pancreatic cancer and pyloric obstruction underwent surgical gastrojejunostomy. Malignant biliary obstruction appeared eight months after surgery and was managed with endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS). Subsequently, afferent limb obstruction caused by cancer invasion occurred. Although an intestinal metal stent could not be placed, a biliary metal stent was deployed via the HGS route, which successfully decompressed the afferent limb; the abdominal symptoms subsequently disappeared. In future similar cases, decompression of the dilated intestine through the HGS and biliary stent might be a viable treatment option.

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