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Updated: Aug 7, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
A temporary endoscopic solution that significantly improves the prognosis of Bouveret's syndrome
S Vigneri1, A Scialabba, R Termini
1Institute of Internal Medicine and Geriatrics, University of Palermo, Italy.
Abstract:
We report the case of a 73-year-old woman who was hospitalized for mild abdominal pain after her referral following a diagnostic assessment of acute lithiasic cholecystitis. After the spontaneus regression of her painful symptoms and fever and several days of well-being, her clinically acute abdominal features suddenly showed an obstruction of the upper gastrointestinal tract. An emergency esophagogastroduodenoscopy (EGDS) confirmed that a large gallstone completely obstructed the pylorus as previously demonstrated by an ultrasound examination of the gallbladder. During the course of endoscopy, removal of the gallstone from the duodenum was achieved by pulling it into the stomach; the patient underwent an operation, the gallstone was removed, and the cholecystoduodenal fistula resolved. Postoperative procedures and recovery were rapid and favorable.

