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Year : 2017  |  Volume : 6  |  Issue : 7  |  Page : 32-33

Biliary derivation by endoscopic ultrasound from gastric body in a patient with subtotal gastrectomy by gastric cancer

Advanced Endoscopy University of Caldas, Union de Cirujanos Sas Manizales, Colombia

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2303-9027.212355

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We present a biliary derivation from the gastric body in a patient with subtotal gastrectomy and anastomosis type Billroth I. The patient had a tumor obstruction of distal coledoco. The patient was with ictericia and the examinations indicated obstructive patron. A gastric transluminal derivation is made to common hepatic. Steps are as given below:
  1. Endosonography that locates the tumor obstruction of the coledoco shows the dilated hepatic conduct;
  2. Doppler signals are made that discharge vessels in the puncture route;
  3. The punction was made in gastric body with endosonographic window direct to the dilated common hepatic conduct. The puncton is performed with Boston Scientific 19-gauge needle;
  4. Bile was aspirated and contrast was injected to delineate the anatomy;
  5. We pass a hydrophilic guide of W. Cook 0.035 mm and after introduce a cystotomy of 6 Fr;
  6. Dilated the track is passed an autoexpandible stent covered of 60/10 mm.
Patient evolves satisfactorily.

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