Project description:Video 1EUS-directed transgastric ERCP in twice-surgically-altered anatomy: Roux-en-Y gastric bypass conversion of a sleeve gastrectomy.

| S-EPMC10793384 | biostudies-literature

Stapling Through a Bougie During Sleeve Gastrectomy in a Superobese Patient-a Video Vignette.

Project description:PurposeBariatric-metabolic surgery in superobese patients (BMI > 50 kg/m2) is very challenging indeed with little room for error. In many cases, a two-step procedure is required, since more complex primary bariatric procedures can be technically demanding and bearing a relevant risk for the patient. At our institution, laparoscopic sleeve gastrectomy (SG) is the preferred primary procedure, followed by a conversion to either SADI-S or Roux-en-Y gastric bypass (RYGB) after initial weight loss is achieved [1, 2]. This video aims at demonstrating the conversion from primary SG to RYGB due to an adverse event in a 45-year-old superobese female patient (weight, 170 kg; BMI, 73 kg/m2).MethodsAn intraoperative laparoscopic video has been anonymized and edited to demonstrate the course of the operation on the patient mentioned above.ResultsThe start of the procedure was uneventful. After a successful mobilization of the greater curvature, the stomach was resected with an electronic stapling device guided by a firm 36-french bougie (Rüsch, Germany) towards the angle of His. Due to a limited view, a stapler was placed over the bougie, which resulted in the stomach being subtotally transected, the staples attaching the bougie to the sleeve about 5 cm from the gastroesophageal junction. Salvage surgery after removing the remnants of the bougie was a conversion to RYGB.ConclusionWhen performing a bariatric-metabolic surgery in superobese patients, an extended skill level is required to provide a solution, should anything go wrong. Therefore, we suggest bariatric-metabolic surgery in superobese patients to be performed solely and specifically at high-volume centres.

| S-EPMC7467964 | biostudies-literature

EUS-directed transgastric ERCP.

Project description: Not available

| S-EPMC6098706 | biostudies-literature

EUS-guided through-the-needle microbiopsy of pancreatic cysts: Technical aspects (with video).

Project description:Pancreatic cystic lesions are frequently encountered and diagnostically challenging as some of the cysts may have malignant potential (mucinous) while others are completely benign (serous). EUS-guided through-the-needle biopsy (EUS-TTNB) of the cyst wall has recently been introduced as an alternative to cyst fluid cytology. Several studies have shown that microbiopsies outperform cytology in terms of distinction between mucinous and nonmucinous lesions, but also in determining the specific cyst diagnosis. However, little is known about the technical aspects of tissue sampling with TTNB. Herein, we summarize our experience with the procedure in a tertiary referral center and discuss indications, technical aspects, and safety of the procedure. Most adverse events (AEs) associated with the procedure are mild, but there is emerging evidence that the rate of postprocedural pancreatitis is higher compared to standard fine-needle aspiration. The added diagnostic yield should therefore be placed in perspective with an increased risk of AEs. Prospective studies are warranted to fully identify which patient groups could benefit from EUS-TTNB.

| S-EPMC7529000 | biostudies-literature

Antegrade brushing cytology through the EUS-guided pancreatic duct drainage route (with video).

Project description: Not available

| S-EPMC9059796 | biostudies-literature

Mediastinal extension of a progressively enlarging pseudocyst treated by EUS-guided transgastric drainage in a child: A rare case report (with video).

Project description: Not available

| S-EPMC10134936 | biostudies-literature

EUS-FNA of a lesion in the pancreatic head using a forward-viewing echoendoscope in a patient with Billroth II gastrectomy (with video).

Project description: Not available

| S-EPMC9258016 | biostudies-literature

Single-session EUS-directed transgastric endoscopic retrograde cholangiopancreatography (EDGE) and EUS-guided gallbladder drainage is safe and feasible.

Project description:Video 1Single-session EDGE with ERCP and EUS gallbladder drainage.