Ecoendoscopy guided hepaticogastrostomy for management of hepatolithiasis and anastomotic stricture after Roux en Y hepaticojejunostomy

• Autores: Chirinos-Vega, Juan Antonio, Ponce de León Molina, Oscar Eduardo
• Formato: artículo
• Fecha de Publicación: 2025
• Institución: Sociedad de Gastroenterología del Perú
• Repositorio: Revista de Gastroenterología del Perú
• Lenguaje: español
• OAI Identifier: oai:ojs.revistagastroperu.com:article/1756
• Enlace del recurso: https://revistagastroperu.com/index.php/rgp/article/view/1756
• Nivel de acceso: acceso abierto
• Materia: Ecoendoscopía; Colestasis Intrahepática; Colangiopancreatografia Retrógrada Endoscópica; Endosonography; Cholestasis, Intrahepatic; Cholangiopancreatography, Endoscopic Retrograde

Endoscopic ultrasound-guided anterograde cholangiopancreatography (EUS-guidedAPC) allow us to address pathologies of the bile duct that are not treatable by endoscopicretrograde cholangiography (ERCP), such as: post-surgical benign strictures in alteredanatomy, hepatolithiasis, gastric outlet obstruction, among others. Previously, when ERCPwas not effective, surgical interventions such as Hepaticojejunostomy (HJ) or percutaneoustransperietohepatic drainage (PTHD) were resorted to. However, EUS-guided APC hasbeen shown to have greater clinical success, be less invasive and have a lower incidenceof complications. We present the case of a 61-years-old patient with a history of HJ bypasssurgery who presented abdominal pain due to hepatholitiasis and post-anastomosis benignbiliary stricture, in whom the antegrade technique was performed by endoscopic ultrasoundthrough the proximal stomach, called hepaticogastrostomy (HG) with good results.