Abstract

FORERO PINEROS, Elías Alfonso; GALASSO, Doménico; BORIES, Erwan  and  GIOVANNINI, Marc. Endoscopic Ultrasound Guided Biliopancreatic Diversion: Case Description and Literature Review. Rev Col Gastroenterol [online]. 2013, vol.28, n.4, pp.339-351. ISSN 0120-9957.

In this paper we present the first reported case of endoscopic ultrasound-guided hepatic-gastrostomy, performed on a patient with a history of bariatric surgery (gastric banding). We review the patient’s clinical history and the technology and accessories used. This case report is supplemented with a detailed and updated review of the medical literature regarding endoscopic ultrasound-guided biliary-pancreatic diversions. These procedures are rapidly developing in a way that is increasing the therapeutic armory for patients who require biliary or pancreatic derivations but who do not meet the requirements for endoscopic retrograde cholangiopancreatography (ERCP), and who are not candidates for, or who reject, the option of percutaneous biliary bypass. These procedures include the hepatic gastrostomy guided by endoscopic ultrasound, biliary-pancreatic rendezvous guided by endoscopic ultrasound, endoscopic ultrasound-guided choledochoduodenostomy, endoscopic ultrasonography-guided cholecystogastrostomy and endoscopic ultrasound-guided pancreatic gastrostomy. This article provides a technical description of each of these procedures and the accessories required. Finally, we present patient management following the guide of the most experienced pioneers of these techniques in the world. These procedures already have a well-recognized place in the therapeutic armory for patients who require this kind of diversion.

Keywords : Endoscopic ultrasound; hepaticogastrostomy; choledochoduodenostomy; rendez-vous; pancreaticogastrostomy.

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