Related Experiment Video
Updated: Feb 11, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Needle-Knife Fistulotomy for the Rescue: An Unusual Cause of Iatrogenic Extrahepatic Biliary Obstruction
Laura L Ulmer1, Lokesh K Jha1, Neil Bhogal1
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, 982000 Nebraska Medical Ctr, Omaha, NE 68198-2000, USA.
Abstract:
A 71-year-old male presented to our institution with cholestatic hepatitis after having recently undergone upper endoscopy for treatment of gastrointestinal bleeding. Further investigation with endoscopic retrograde cholangiopancreatography revealed a hemostatic clip on the ampulla of Vater. After initial attempts at cannulation of the common bile duct were unsuccessful, biliary decompression was achieved by use of needle-knife fistulotomy. A common bile duct stent was placed and the liver function tests improved prior to discharge.
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