Related Experiment Video
Updated: Sep 30, 2025
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Successful endoscopic drainage of malignant obstructive jaundice in patients with situs inversus totalis: Two cases
You Kui Gao1, Song Hang Liu1, Shui An Xie1
1Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Guangzhou Medical University, No. 250 Changgang East Street, Guangzhou 510220, Guangdong Province, China.
Introduction And Importance:
Although endoscopic techniques in situs inversus totalis (SIT) have been reported, endoscopic retrograde cholangiopancreatography (ERCP) in patients with situs inversus totalis (SIT) remains difficult to every hepatobiliary surgeon. To investigate the differences of each position, ERCP was used to perform through two different body positions.
Case Presentation:
Herein we report a 63-year-old woman presented with epigastric pain for 2 months and jaundice for 7 days and a 51-year-old man with presented jaundice for 7 days. Preoperative examination revealed situs inversus totalis and gallbladder carcinoma with diffuse dilatation of the biliary tree. ERCP was used to perform by using two different body positions. In addition, the ERCP combined with percutaneous transhepatic cholangial drainage (PTCD) was performed in the second patient.
Clinical Discussion:
The different endoscopic approaches are used in different positions, the endoscopist should be familiar with mirror symmetrical anatomy. We argue that the prone position has a higher surgical success rate and ERCP combined with PTCD will be easier in SIT patients.
Conclusion:
ERCP in SIT patients is generally safe and it will be easier by combining with PTCD.
