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CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2021; 12(01): 054-055
DOI: 10.1055/s-0040-1718861
Case Report

Permanent External Biliary Catheter: A Difficult Problem Managed by Rescue Technique of Hepatico-cholecysto-gastrostomy

Vikas Singla
1   Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences, Sir Ganga Ram Hospital, New Delhi, India
,
Ajit Kumar Yadav
2   Department of Intervention Radiology, Sir Ganga Ram Hospital, New Delhi, India
,
Anil Arora
1   Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences, Sir Ganga Ram Hospital, New Delhi, India
,
Arun Gupta
2   Department of Intervention Radiology, Sir Ganga Ram Hospital, New Delhi, India
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Abstract

Percutaneous biliary drainage is commonly performed procedure after failure of ERCP in patients with biliary obstruction. Failure to internalization can lead to permanent external catheter. In the present case, problem of external biliary catheter was solved with hepaticocholecystogastrostomy. Guidewire from the external drain site could not be passed across the stricture, instead it was entering in the gall bladder. This was used as an opportunity to internalize the catheter. First EUS guided cholecystogastrostomy was performed, followed by placement of stent between right biliary system and the stomach, through the cholecystogastrostomy stent. This led to drainage of right biliary system into the stomach, and the external catheter could be removed.

Keywords

cholecystogastrostomy - endoscopic ultrasound - permanent external biliary catheter


Publication History

Article published online:
22 January 2021

© 2020. Society of Gastrointestinal Endoscopy of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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