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Updated: Jul 19, 2025

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Endoscopic Ultrasound-Guided Transgastric Shunt Obliteration for Recurrent Hepatic Encephalopathy
Sahaj Rathi1, Amrita Kalantri2, Arpit Shastri1
1Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Introduction:
Occlusion of spontaneous portosystemic shunts (SPSSs) in patients with cirrhosis may be required in recurrent or refractory hepatic encephalopathy. We describe a novel method for occlusion of SPSS using endoscopic ultrasound (EUS).
Methods:
EUS-guided transgastric shunt obliteration was performed by injecting glue and coils directly into SPSS.
Results:
EUS-guided transgastric shunt obliteration was performed for 7 patients in 9 sessions. Complete cessation of Doppler flow was achieved in 6/7 cases. Adequate clinical response was observed in 6/7 patients. No procedure-related severe adverse events were seen.
Discussion:
This novel technique is a potentially effective and efficient method for shunt obliteration.
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