Endoscopic Ultrasound-Guided Hepaticogastrostomy Is Effective for Repeated Recurrent Cholangitis after Surgery: Two...

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Biliary Interventions

Background:

• Recurrent cholangitis is a serious complication of benign biliary stenosis, often refractory to conventional endoscopic therapies.
• Previous treatments like double-balloon endoscopy failed to resolve anastomotic stenosis in the reported cases.
• Metallic stents (MS) are explored as a therapeutic option for complex biliary strictures.

Observation:

• Two patients with recurrent cholangitis secondary to benign biliary stenosis were treated with endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS).
• The EUS-HGS procedure involved the placement of a covered metallic stent (C-MS).
• Both patients experienced successful stent placement and resolution of acute cholangitis symptoms.

Findings:

• EUS-HGS with MS placement led to a significant reduction in the recurrence of cholangitis.
• The covered metallic stent (C-MS) proved effective in managing the biliary stenosis and preventing further inflammatory episodes.
• The procedure demonstrated both efficacy and safety in this patient cohort.

Implications:

• EUS-HGS using metallic stents presents a viable and effective treatment strategy for recurrent cholangitis in patients with benign biliary stenosis.
• This approach should be considered for patients who have failed less invasive endoscopic interventions.
• Further research into EUS-HGS with MS for biliary disorders may expand its clinical application.