Endoscopic intra-abdominal rescue therapy of a dislodged EUS-guided hepaticogastrostomy stent

摘要

EUS-guided hepaticogastrostomy (HGS) is a_ well- accepted alternative treatment for patients with biliary obstruction and failed ERCP. The average technical success and adverse event rates of this EUS intervention have been reported to be 90% and 17%, respectively. Adverse events include abdominal pain, hemorrhage, pneumoperitoneum, infection, biliary leakage, and dislodged stents. In cases of dislodged stents, the patients have early acute biliary peri- tonitis, given a significant hole in the liver and the stom- ach. These patients can deteriorate quickly and need urgent surgical repair. However, most of those patients have advanced malignant diseases, and with its increased morbidity risk, an endoscopic approach would definitely be warranted.