Skip Navigation
Skip to contents

Clin Endosc : Clinical Endoscopy



Page Path
HOME > Search
10 "Anastomosis"
Article category
Publication year
Focused Review Series: Endoscopic Management for Biliary Stricture after Liver Transplantation
Magnetic Compression Anastomosis for the Treatment of Post-Transplant Biliary Stricture
Sung Ill Jang, Jae Hee Cho, Dong Ki Lee
Clin Endosc 2020;53(3):266-275.   Published online May 29, 2020
AbstractAbstract PDFPubReaderePub
A number of different conditions can lead to a bile duct stricture. These strictures are particularly common after biliary operations, including living-donor liver transplantation. Endoscopic and percutaneous methods have high success rates in treating benign biliary strictures. However, these conventional methods are difficult to manage when a guidewire cannot be passed through areas of severe stenosis or complete obstruction. Magnetic compression anastomosis has emerged as an alternative nonsurgical treatment method to avoid the mortality and morbidity risks of reoperation. The feasibility and safety of magnetic compression anastomosis have been reported in several experimental and clinical studies in patients with biliobiliary and bilioenteric strictures. Magnetic compression anastomosis is a minimally traumatic and highly effective procedure, and represents a new paradigm for benign biliary strictures that are difficult to treat with conventional methods.


Citations to this article as recorded by  
  • Y–Z deformable magnetic ring for the treatment of rectal stricture: A case report and review of literature
    Miao-Miao Zhang, Huan-Chen Sha, Yuan-Fa Qin, Yi Lyu, Xiao-Peng Yan
    World Journal of Gastroenterology.2024; 30(6): 599.     CrossRef
  • A Short Fully Covered Self-Expandable Metal Stent for Management of Benign Biliary Stricture Not Caused by Living-Donor Liver Transplantation
    See-Young Lee, Sung-Ill Jang, Moon-Jae Chung, Jae-Hee Cho, Min-Young Do, Hye-Sun Lee, Juyeon Yang, Dong-Ki Lee
    Journal of Clinical Medicine.2024; 13(5): 1186.     CrossRef
  • Research progress on anatomy reconstruction of rat orthotopic liver transplantation
    Weikang Wu, Juzheng Yuan, Fuyuan Liu, Lu Liu, Xudan Wang, Xiao Li, Kaishan Tao
    Transplantation Reviews.2024; 38(2): 100841.     CrossRef
  • Percutaneous Transhepatic Sphincterotome–Guided Management of Post–Living Donor Liver Transplant Biliary Anastomotic Stricture: An Innovative Approach
    Usman Iqbal Aujla, Imran Ali Syed, Ahmad Karim Malik, Muhammad Ramzan, Abdullah Saeed
    ACG Case Reports Journal.2024; 11(3): e01288.     CrossRef
  • Biliary Anastomotic Strictures after Liver Transplantation: Current Status and Advances
    鑫 林
    Advances in Clinical Medicine.2024; 14(03): 1477.     CrossRef
  • Endoscopic application of magnetic compression anastomosis: a review
    Guo Zhang, Zheng Liang, Guiping Zhao, Shutian Zhang
    Journal of Gastroenterology and Hepatology.2024;[Epub]     CrossRef
  • Magnetic compression anastomosis of post-cholecystectomy benign biliary stricture using modified accessories (with video)
    Radhika Chavan, Rushil Solanki, Maitrey Patel, Chaiti Gandhi, Milind Prajapati, Sanjay Rajput
    Indian Journal of Gastroenterology.2024;[Epub]     CrossRef
  • Effect of tissue tension on magnetic compression anastomosis of digestive tract
    Miaomiao Zhang, Jia Ma, Aihua Shi, Ruimin Gong, Xuhe Zhao, Qiuye Zhong, Linxin Shen, Yi Lyu, Xiaopeng Yan
    Scientific Reports.2024;[Epub]     CrossRef
  • Clinical effect of magnetic compression anastomosis on ureterostenosis after kidney transplantation
    Jiangwei Zhang, Wujun Xue, Puxun Tian, Hang Yan, Jin Zheng, Xiao Li, Ying Wang, Xiaoming Ding, Yi Lyu
    Chinese Medical Journal.2023; 136(8): 1006.     CrossRef
  • The Evolving Use of Magnets in Surgery: Biomedical Considerations and a Review of Their Current Applications
    William G. Lee, Lauren L. Evans, Sidney M. Johnson, Russell K. Woo
    Bioengineering.2023; 10(4): 442.     CrossRef
  • Post-transplant biliyer darlığın tedavisinde manyetik kompresyon yöntemi: Olgu sunumu
    Azar ABİYEV, Harun KÜÇÜK, Seçkin ÖZGÜL, Serkan DUMANLI, Gülden BİLİCAN, Mehmet Koray AKKAN, Murat KEKİLLİ
    Akademik Gastroenteroloji Dergisi.2023; 22(3): 160.     CrossRef
  • Magnetic Compression Anastomosis Is a Good Treatment Option for Patients with Completely Obstructed Benign Biliary Strictures: A Case Series Study
    Bülent Ödemiş, Batuhan Başpınar, Muharrem Tola, Serkan Torun
    Digestive Diseases and Sciences.2022; 67(10): 4906.     CrossRef
  • Biliary Complications after Living Donor Liver Transplantation Differ from Those after Deceased Donor Liver Transplantation
    Sung Ill Jang, Dong Ki Lee
    Gut and Liver.2022; 16(2): 145.     CrossRef
  • Role of ERCP in Benign Biliary Strictures
    Tommaso Schepis, Ivo Boškoski, Andrea Tringali, Guido Costamagna
    Gastrointestinal Endoscopy Clinics of North America.2022; 32(3): 455.     CrossRef
  • Validity of MDCT cholangiography in differentiating benign and malignant biliary obstruction
    Ahmed M. Alsowey, Ahmed F. Salem, Mohamed I. Amin
    Egyptian Journal of Radiology and Nuclear Medicine.2021;[Epub]     CrossRef
  • Cholangioscopy and double-balloon enteroscopy mediated “sandwich puncture” of a completely closed choledochojejunostomy
    Toshio Fujisawa, Hiroyuki Isayama, Tomoyoshi Shibuya, Ko Tomishima, Shigeto Ishii
    VideoGIE.2021; 6(7): 325.     CrossRef
  • Magnetic compression anastomosis via EUS-guided hepaticogastrostomy for recanalization of complete common hepatic bile duct transection
    Yingluk Sritunyarat, Thawee Ratanachu-Ek, Siriboon Attasaranya, Wiriyaporn Ridtitid, Rungsun Rerknimitr
    VideoGIE.2021; 6(8): 365.     CrossRef
  • Magnetic compression anastomosis for treatment of post-transplant biliary stricture: A case report with dual-graft living donor liver transplantation
    Dong-Hwan Jung, Do Hyun Park, Gi-Won Song, Chul-Soo Ahn, Deok-Bog Moon, Shin Hwang
    Annals of Liver Transplantation.2021; 1(2): 174.     CrossRef
  • 10,673 View
  • 174 Download
  • 11 Web of Science
  • 18 Crossref
Close layer
De-novo Gastrointestinal Anastomosis with Lumen Apposing Metal Stent
Deepanshu Jain, Ankit Chhoda, Abhinav Sharma, Shashideep Singhal
Clin Endosc 2018;51(5):439-449.   Published online September 27, 2018
AbstractAbstract PDFPubReaderePub
Gastric outlet obstruction, afferent or efferent limb obstruction, and biliary obstruction among patients with altered anatomy often require surgical intervention which is associated with significant morbidity and mortality. Endoscopic dilation for benign etiologies requires multiple sessions, whereas self-expandable metal stents used for malignant etiologies often fail due to tumor in-growth. Lumen apposing metal stents, placed endoscopically with the intent of creating a de-novo gastrointestinal anastomosis bypassing the site of obstruction, can potentially achieve similar efficacy, with a much lower complication rate. In our study cohort (n=79), the composite technical success rate and clinical success rate was 91.1% (72/79) and 97.2% (70/72), respectively. Five different techniques were used: 43% (34/79) underwent the balloon-assisted method, 27.9% (22/79) underwent endoscopic ultrasound-guided balloon occluded gastro-jejunostomy bypass, 20.3% (16/79) underwent the direct technique, 6.3% (5/79) underwent the hybrid rendezvous technique, and 2.5% (2/79) underwent natural orifice transluminal endoscopic surgery (NOTES)-assisted procedure. All techniques required an echoendoscope except NOTES. In all, 53.2% (42/79) had non-cautery enhanced Axios stent, 44.3% (35/79) had hot Axios stent, and 2.5% (2/79) had Niti-S spaxus stent. Symptom-recurrence was seen in 2.8%, and 6.3% had a complication (bleeding, abdominal pain or peritonitis). All procedures were performed by experts at centers of excellence with adequate surgical back up.


Citations to this article as recorded by  
  • Salvage endoscopic ultrasound-guided gastrojejunostomy as a bridge to definitive surgical therapy for duodenal adenocarcinoma presenting with duodenal stent obstruction
    Tiffany Z. Yu, Abishek Agnihotri, Richard Zheng, Babar Bashir, Nayeem Nasher, Charles J. Yeo, Avinoam Nevler, Harish Lavu, Wilbur B. Bowne, Anand Kumar
    Clinical Journal of Gastroenterology.2023; 16(3): 387.     CrossRef
  • The Use of Palliative Endoscopic Ultrasound-guided Enterostomy to Treat Small Bowel Obstruction in Two Patients with Advanced Malignancies
    Ji Hong Oh, Seung Goun Hong
    The Korean Journal of Medicine.2022; 97(3): 191.     CrossRef
  • Short benign ileocolonic anastomotic strictures - management with bi-flanged metal stents: Six case reports and review of literature
    Panagiotis Kasapidis, Georgios Mavrogenis, Dimitrios Mandrekas, Fateh Bazerbachi
    World Journal of Clinical Cases.2022; 10(28): 10162.     CrossRef
  • Long-term placement of lumen-apposing metal stent after endoscopic ultrasound-guided duodeno- and jejunojejunal anastomosis for direct access to excluded jejunal limb
    Gianfranco Donatelli, Fabrizio Cereatti, Andrea Spota, David Danan, Thierry Tuszynski, Jean-Loup Dumont, Serge Derhy
    Endoscopy.2021; 53(03): 293.     CrossRef
  • ERCP in patient with Roux-en-Y gastric bypass and high grade duodenal stricture across dual lumen-apposing metal stents
    Kornpong Vantanasiri, Guru Trikudanathan
    Endoscopy.2021; 53(05): E189.     CrossRef
  • Endoscopic sigmoidorectal reanastomosis using a dual endoscope technique: rendezvous single-balloon enteroscopy and endoscopic ultrasound
    Sławomir Kozieł, Katarzyna Kozłowska-Petriczko, Katarzyna M. Pawlak, Jan Petriczko, Anna Wiechowska-Kozłowska
    Endoscopy.2021; 53(07): E257.     CrossRef
  • Lumen-Apposing Metal Stent Used to Treat Malignant Esophageal Stricture
    Ryan B. Mirchin, Syed Kashif Mahmood
    ACG Case Reports Journal.2020; 7(3): e00362.     CrossRef
  • Lumen-apposing metal stent use to maintain a surgical anastomosis
    Abdulla Nasser, Marc Cullen, Mohammed Barawi
    VideoGIE.2020; 5(10): 494.     CrossRef
  • Fluoroscopy-Guided Gastrojejunostomy Creation with Lumen-Apposing Metal Stent in a Porcine Model
    Jingui Li, Tao Gong, Jiaywei Tsauo, He Zhao, Xiaowu Zhang, Mingchen Sang, Xiao Li
    CardioVascular and Interventional Radiology.2020; 43(11): 1687.     CrossRef
  • 5,084 View
  • 125 Download
  • 8 Web of Science
  • 9 Crossref
Close layer
Focused Review Series: Pancreatobiliary endoscopy in altered gastointestinal anatomy
Percutaneous Transhepatic Cholangioscopy in Bilioenteric Anastomosis Stricture
Hyoung-Chul Oh
Clin Endosc 2016;49(6):530-532.   Published online September 19, 2016
AbstractAbstract PDFPubReaderePub
Bilioenteric anastomosis strictures are a serious complication of biliary surgery, and often result in recurrent cholangitis, choledocholithiasis, biliary cirrhosis, and hepatic failure. Bilioenteric reconstructive surgery is the standard treatment of choice for such complications. However, percutaneous transhepatic cholangioscopy (PTCS), also known as per-oral endoscopic-guided intervention, is a less invasive procedure that is becoming an increasingly popular alternative. This review describes the PTCS procedure (including the preparation process), as well as the diagnostic and therapeutic role of PTCS in bilioenteric anastomosis strictures.


Citations to this article as recorded by  
  • Management of anastomotic biliary stricture through utilizing percutaneous transhepatic cholangioscopy
    Aimaiti Yasen, Jun Feng, Tian-Xing Dai, Can-Hua Zhu, Run-Bin Liang, Zhi-Hong Liao, Kai Li, Yu-Hong Cai, Guo-Ying Wang
    Clinical Radiology.2024; 79(6): e868.     CrossRef
  • Percutaneous Biliary Endoscopy: History, Indications, Techniques, and Outcomes
    Manisha Naganatanahalli, Deven Desai, Abraham Levitin, Sasan Partovi, Justin Guan
    Digestive Disease Interventions.2024;[Epub]     CrossRef
  • Tips and Techniques for Traversing the Impassable Biliary Stricture
    Nicholas T. Befera, Brendan C. Cline, Jonathan G. Martin, Paul V. Suhocki, Charles Y. Kim
    Digestive Disease Interventions.2023; 07(01): 071.     CrossRef
  • Clinical Outcomes of Percutaneous Biliary Endoscopy: A 7-Year Single-Institution Experience
    Justin J. Guan, Ryan W. England, Siddhi Hegde, Sharon Pang, Alex J. Solomon, Kelvin K. Hong, Harjit Singh
    Journal of Vascular and Interventional Radiology.2023; 34(4): 660.     CrossRef
  • Percutaneous Transhepatic Cholangioscopy Interventions—Updates
    Zachary M. Haber, Ravi N. Srinivasa, Edward Wolfgang Lee
    Journal of Clinical Gastroenterology.2023; 57(9): 879.     CrossRef
  • A Unique Approach to Obtaining Tissue in a Difficult to Access Indeterminate Biliary Stricture: Percutaneous Cholangioscopy and Biopsy
    Abigail Schubach, Amulya Penmetsa, Ashwani Sharma, Shivangi Kothari
    ACG Case Reports Journal.2023; 10(7): e01095.     CrossRef
  • Manejo de una estenosis de la anastomosis bilioentérica con ablación por radiofrecuencia intraluminal
    P. Valdez-Hernández, M. Ylhuicatzi-Durán, M. Guerrero-Hernández, R. Alvarado-Bachmann, D. Angulo-Molina
    Revista de Gastroenterología de México.2023; 88(4): 439.     CrossRef
  • Intraluminal radiofrequency ablation as stricture management in biliary-enteric anastomosis
    P. Valdez-Hernández, M. Ylhuicatzi-Durán, M. Guerrero-Hernández, R. Alvarado-Bachmann, D. Angulo-Molina
    Revista de Gastroenterología de México (English Edition).2023; 88(4): 439.     CrossRef
  • Endoscopic biliary therapy in the era of bariatric surgery
    Harry Martin, Tareq El Menabawey, Orla Webster, Constantinos Parisinos, Michael Chapman, Stephen P Pereira, Gavin Johnson, George Webster
    Frontline Gastroenterology.2022; 13(2): 133.     CrossRef
  • Efficacy and Safety of Percutaneous Transhepatic Cholangioscopy with the Spyglass DS Direct Visualization System in Patients with Surgically Altered Anatomy: A Pilot Study
    Hyung Ku Chon, Keum Ha Choi, Sang Hyun Seo, Tae Hyeon Kim
    Gut and Liver.2022; 16(1): 111.     CrossRef
  • A case of a smooth transition to subsequent percutaneous transjejunal biliary intervention for hepatolithiasis after biliary reconstruction by adding jejunostomy during an emergency operation for perforation due to balloon-assisted endoscopy
    Tetsuya Ishizawa, Toshikazu Kobayashi, Naohiko Makino, Akiko Matsuda, Yasuharu Kakizaki, Shuichiro Sugawara, Koki Ashino, Ryosuke Takahashi, Fuyuhiko Motoi, Yoshiyuki Ueno
    Clinical Journal of Gastroenterology.2021; 14(2): 678.     CrossRef
  • One-step percutaneous transhepatic cholangioscopic lithotripsy in patients with choledocholithiasis
    Ping Wang, Haisu Tao, Chengcheng Liu, Xinghua Zhou, Beiwang Sun, Canhua Zhu, Kun Li, Zhaoshan Fang
    Clinics and Research in Hepatology and Gastroenterology.2021; 45(2): 101477.     CrossRef
  • Clinical application of laparoscopy combined with choledochoscopy in patients with bilioenteric anastomotic stricture with access via the jejunal loops
    Yi Zhu, Jinhai Li, Minjie Xie, Jing Jin, Jianying Lou
    Journal of International Medical Research.2021; 49(7): 030006052110345.     CrossRef
  • Interventional radiology techniques in the treatment of cholangiolithiasis: indications, efficacy, accessibility
    Jerik Narimanovich Prazdnikov, Grigory Alexandrovich Baranov, Dmitry Ravilyevich Zinatulin, Vladimir Vladimirovich Naletov, Rifat Khamitovich Umyarov
    Hirurg (Surgeon).2021; (11-12): 9.     CrossRef
  • Biliary complications in recipients of living donor liver transplantation: A single-centre study
    Reginia Nabil Guirguis, Ehab Hasan Nashaat, Azza Emam Yassin, Wesam Ahmed Ibrahim, Shereen A Saleh, Mohamed Bahaa, Mahmoud El-Meteini, Mohamed Fathy, Hany Mansour Dabbous, Iman Fawzy Montasser, Manar Salah, Ghada Abdelrahman Mohamed
    World Journal of Hepatology.2021; 13(12): 2081.     CrossRef
  • Interventional radiology techniques in the treatment of cholangiolithiasis: indications, efficacy, accessibility
    Jerik Narimanovich Prazdnikov, Grigory Alexandrovich Baranov, Dmitry Ravilyevich Zinatulin, Vladimir Vladimirovichl Naletov , Rifat Khamitovich Umyarov
    Hirurg (Surgeon).2021; (6): 9.     CrossRef
  • Percutaneous approach and rendezvous technique for the management of a cholangiolithiasis complicated by obstructive jaundice
    E. N. Prazdnikov, D. R. Zinatulin, V. P. Shevchenko, R. Kh. Umyarov, M. A. Red'kina, M. S. Khoptyar
    Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery.2020; 25(1): 48.     CrossRef
  • Endoscopic management of anastomotic stricture after living-donor liver transplantation
    Dong Wook Lee, Jimin Han
    The Korean Journal of Internal Medicine.2019; 34(2): 261.     CrossRef
  • Indications for Single-Operator Cholangioscopy and Pancreatoscopy: an Expert Review
    Enrique Pérez-Cuadrado-Robles, Pierre H. Deprez
    Current Treatment Options in Gastroenterology.2019; 17(3): 408.     CrossRef
  • Cholangiolithiasis postliver transplantation: Successful treatment utilizing percutaneous transhepatic cholangioscopy and laser lithotripsy
    Nariman Nezami, Liliya Benchetrit, Igor Latich, Todd Schlachter
    Radiology Case Reports.2019; 14(12): 1459.     CrossRef
  • Antegrade approach for cholangiolithiasis complicated by mechanical jaundice
    E. N. Prazdnikov, G. A. Baranov, D. R. Zinatulin, R. Kh. Umyarov, V. P. Shevchenko, N. M. Nikolayev
    Khirurgiya. Zhurnal im. N.I. Pirogova.2018; (1): 21.     CrossRef
  • Surgical management of cholangiolithiasis
    E. N. Prazdnikov, D. R. Zinatulin, V. P. Shevchenko, R. Kh. Umiarov, V. A. Eremeev, M. A. Redkina, M. S. Khoptyar
    Endoskopicheskaya khirurgiya.2018; 24(4): 7.     CrossRef
  • Percutaneous transhepatic cholangioscopy using SpyGlassDS for an anastomotic stenosis after choledochojejunostomy
    Yuki Fujii, Shinsuke Koshita, Kei Ito
    Digestive Endoscopy.2018; 30(6): 806.     CrossRef
  • Klinischer Stellenwert der modularen Cholangioskopie
    C. Bojarski, F. Turowski
    Der Gastroenterologe.2017; 12(3): 202.     CrossRef
  • 7,599 View
  • 155 Download
  • 15 Web of Science
  • 24 Crossref
Close layer
Case Reports
Single Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients Who Underwent a Gastrectomy with Roux-en-Y Anastomosis: Six Cases from a Single Center
Jae Seung Soh, Dong-Hoon Yang, Sang Soo Lee, Seohyun Lee, Jungho Bae, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang
Clin Endosc 2015;48(5):452-457.   Published online September 30, 2015
AbstractAbstract PDFPubReaderePub

Patients with altered anatomy such as a Roux-en-Y anastomosis often present with various pancreaticobiliary problems requiring therapeutic intervention. However, a conventional endoscopic approach to the papilla is very difficult owing to the long afferent limb and acute angle of a Roux-en-Y anastomosis. Balloon-assisted enteroscopy can be used for endoscopic retrograde cholangiopancreatography (ERCP) in patients with altered anatomy. We experienced six cases of Roux-en-Y anastomosis with biliary problems, and attempted ERCP using single balloon enteroscopy (SBE). SBE insertion followed by replacement with a conventional endoscope was attempted in five of six patients. The papilla was successfully approached using SBE in all cases. However, therapeutic intervention was completed in only three cases because of poor maneuverability caused by postoperative adhesion. We conclude that in patients with Roux-en-Y anastomosis, the ampulla can be readily accessed with SBE, but longer dedicated accessories are necessary to improve this therapeutic intervention.


Citations to this article as recorded by  
  • Single Balloon Enteroscopy-Guided Endoscopic Retrograde Cholangiopancreatography in Surgically Altered Anatomy: Long vs. Short Type
    Chang-Hwan Park
    The Korean Journal of Pancreas and Biliary Tract.2021; 26(3): 181.     CrossRef
  • Direct Insertion of a Short-Type Single-Balloon Enteroscope and Using a Stent Retriever to Treat Difficult Bile Duct Stones in Surgically Altered Anatomy
    Takashi Sasaki, Naoki Sasahira
    Clinical Endoscopy.2021; 54(6): 937.     CrossRef
  • Single-balloon enteroscopy-assisted ERCP in patients with Roux-en-Y anatomy and choledocholithiasis: do technical improvements mean better outcomes?
    Jesús Espinel Díez, María Eugenia Pinedo Ramos
    Revista Española de Enfermedades Digestivas.2020;[Epub]     CrossRef
  • Application of single balloon enteroscopy-assisted therapeutic endoscopic retrograde cholangiopancreatography in patients after bilioenteric Roux-en-Y anastomosis: Experience of multi-disciplinary collaboration
    Wen-Guang Wu, Lu-Cui Qin, Xiao-Ling Song, Ming-Ning Zhao, Wen-Jie Zhang, Jun Gu, Hao Weng, Ying-Bin Liu, Yi Zhang, Chun-Ying Qu, Lei-Ming Xu, Xue-Feng Wang
    World Journal of Gastroenterology.2019; 25(36): 5505.     CrossRef
  • Comparison between Enteroscopy-Based and Laparoscopy-Assisted ERCP for Accessing the Biliary Tree in Patients with Roux-en-Y Gastric Bypass: Systematic Review and Meta-analysis
    Alberto Machado da Ponte-Neto, Wanderley M. Bernardo, Lara M. de A. Coutinho, Iatagan Rocha Josino, Vitor Ottoboni Brunaldi, Diogo T. H. Moura, Paulo Sakai, Rogério Kuga, Eduardo G. H. de Moura
    Obesity Surgery.2018; 28(12): 4064.     CrossRef
  • Impact of a Newly Developed Short Double-Balloon Enteroscope on Stent Placement in Patients with Surgically Altered Anatomies
    Koichiro Tsutsumi, Hironari Kato, Hiroyuki Okada
    Gut and Liver.2017; 11(2): 306.     CrossRef
  • 8,118 View
  • 79 Download
  • 5 Web of Science
  • 6 Crossref
Close layer
Endoscopic Treatment of Various Gastrointestinal Tract Defects with an Over-the-Scope Clip: Case Series from a Tertiary Referral Hospital
Woong Cheul Lee, Weon Jin Ko, Jun-Hyung Cho, Tae Hee Lee, Seong Ran Jeon, Hyun Gun Kim, Joo Young Cho
Clin Endosc 2014;47(2):178-182.   Published online March 31, 2014
AbstractAbstract PDFPubReaderePub

Recently, increasingly invasive therapeutic endoscopic procedures and more complex gastrointestinal surgeries such as endoscopic mucosal resection, endoscopic submucosal dissection, and novel laparoscopic approaches have resulted in endoscopists being confronted more frequently with perforations, fistulas, and anastomotic leakages, for which nonsurgical closure is desired. In this article, we present our experiences with the use of over-the-scope clip (OTSC) for natural orifice transluminal endoscopic surgery (NOTES) closure, prevention of perforation, anastomotic leakages, and fistula closures. The OTSC is a valuable device for closing intestinal perforations and fistulas, for NOTES closure, and for the prevention of perforation after the excision of a tumor from the proper muscle layer. Furthermore, it seems to be quite safe to perform, even by endoscopists with little experience of the technique.


Citations to this article as recorded by  
  • Experimental Evaluation of the Optimal Suture Pattern With a Flexible Endoscopic Suturing System
    Peter Halvax, Michele Diana, Yoshihiro Nagao, Jacques Marescaux, Lee Swanström
    Surgical Innovation.2017; 24(3): 201.     CrossRef
  • Management of non-acute gastrointestinal defects using the over-the-scope clips (OTSCs): a retrospective single-institution experience
    Joshua S. Winder, Afif N. Kulaylat, Jane R. Schubart, Hassan M. Hal, Eric M. Pauli
    Surgical Endoscopy.2016; 30(6): 2251.     CrossRef
  • Early endoscopic closure of colocutaneous fistula adjacent to unmatured low colorectal anastomosis with the Over-The-Scope Clip (OTSC)
    Constantinos Avgoustou, K. Paraskeva
    Hellenic Journal of Surgery.2016; 88(3): 193.     CrossRef
  • Endoscopic Closure for Full-Thickness Gastrointestinal Defects: Available Applications and Emerging Innovations
    Nobuyoshi Takeshita, Khek Yu Ho
    Clinical Endoscopy.2016; 49(5): 438.     CrossRef
  • 6,131 View
  • 59 Download
  • 3 Web of Science
  • 4 Crossref
Close layer
Percutaneous Cholangioscopic Lithotripsy for Afferent Loop Syndrome Caused by Enterolith Development after Roux-en-Y Hepaticojejunostomy: A Case Report
Seong Hyun Kim, Seok Jeong, Don Haeng Lee, Sung Soo Yoo, Keon-Young Lee
Clin Endosc 2013;46(6):679-682.   Published online November 19, 2013
AbstractAbstract PDFPubReaderePub

Afferent loop obstruction caused by enterolith formation is rare and cannot be easily treated with endoscopy because of the difficulty associated with the nonsurgical removal of enteroliths. A 74-year-old woman was admitted with fever and acute abdominal pain. Clinical features and imaging studies suggested afferent loop obstruction caused by an enterolith after Roux-en-Y hepaticojejunostomy. Percutaneous transhepatic biliary drainage was initially performed because of severe cholangitis with septic shock. The enterolith was located in the jejunal limb adjacent to the hepaticojejunostomy site. Cholangioscopic lithotripsy was performed through the percutaneous transhepatic route to the enterolith, and the fragments were moved into the efferent loop using scope push and saline flush methods. Here, we describe a case of afferent loop syndrome caused by an enterolith that developed after Roux-en-Y hepaticojejunostomy and was treated with percutaneous transhepatic cholangio-enteroscopic lithotripsy.


Citations to this article as recorded by  
  • Migrated Pancreaticojejunal Stent Forming a Stent–Stone Complex in the Jejunum with Resultant Small Bowel Obstruction: A Case Report
    Jiwon Kim, Young Han Kim, Byung-Hee Lee
    Journal of the Korean Society of Radiology.2023; 84(2): 512.     CrossRef
  • Enterolith Causing Afferent Loop Perforation After Distal Gastrectomy
    Naoya Ozawa, Masaki Kanzaki
    Cureus.2023;[Epub]     CrossRef
  • Successful treatment of postoperative nonobstructive recurrent cholangitis by tract conversion surgery after total pancreatectomy: a case report
    Masanori Odaira, Fumiki Toriumi, Shota Hoshino, Nozomi Iwama, Yasuhiro Ito, Takashi Endo, Hirohisa Harada
    Surgical Case Reports.2023;[Epub]     CrossRef
  • Enterolith in Roux limb causing extrahepatic biliary obstruction in a patient with a hepaticojejunostomy: case report and relevant literature review
    Vipan Kumar, Venu Bhargava Mulpuri, Pankaj Gupta, Vikas Gupta
    BMJ Case Reports.2022; 15(3): e246935.     CrossRef
  • Choledochoscopy: An update
    Tsinrong Lee, Thomas Zheng Jie Teng, Vishal G Shelat
    World Journal of Gastrointestinal Endoscopy.2021; 13(12): 571.     CrossRef
  • Roux‐en‐Y enterolith leading to obstruction and ischemic necrosis after pediatric orthotopic liver transplantation
    Ralph C. Quillin, Advaith Bongu, Vania Kasper, Jennifer M. Vittorio, Mercedes Martinez, Steven J. Lobritto, Adam D. Griesemer, James V. Guarrera
    Pediatric Transplantation.2018;[Epub]     CrossRef
  • Recurrent Cholangitis by Biliary Stasis Due to Non-Obstructive Afferent Loop Syndrome After Pylorus-Preserving Pancreatoduodenectomy: Report of a Case
    Yukihiro Sanada, Naoya Yamada, Masanobu Taguchi, Kazue Morishima, Naoya Kasahara, Yuji Kaneda, Atsushi Miki, Yasunao Ishiguro, Akira Kurogochi, Kazuhiro Endo, Masaru Koizumi, Hideki Sasanuma, Takehito Fujiwara, Yasunaru Sakuma, Atsushi Shimizu, Masanobu H
    International Surgery.2014; 99(4): 426.     CrossRef
  • 6,015 View
  • 46 Download
  • 7 Crossref
Close layer
Interventional Endoscopic Ultrasonography: Present and Future
Kwang Hyuck Lee, Jong Kyun Lee
Clin Endosc 2011;44(1):6-12.   Published online September 30, 2011
AbstractAbstract PDFPubReaderePub

The technical advances in endoscopic ultrasonograpy (EUS) and accessories have enabled performing EUS-guided intervention in the pancreas and biliary tract. Many research centers have been performing or investigating EUS-guided drainage, EUS-guided celiac plexus neurolysis and block, EUS-guided anastomosis that includes choledocho-enterostomy and choledocho-gastrostomy, EUS-guided ablation and injection therapy mainly for pancreatic neoplasm, EUS-guided photodynamic therapy and EUS-guided brachytherapy. Some of these are currently clinical applications and others are under investigations in clinical studies or animal models. Further detailed randomized controlled clinical trials and the development of materials will bring us into a new era of therapeutic EUS.


Citations to this article as recorded by  
  • Endoscopic ultrasound-guided ethanol and radiofrequency ablation of pancreatic insulinomas: a systematic literature review
    Ghassan El Sayed, Levente Frim, Jamie Franklin, Raymond McCrudden, Charles Gordon, Safa Al-Shamma, Szabolcs Kiss, Péter Hegyi, Bálint Erőss, Péter Jenő Hegyi
    Therapeutic Advances in Gastroenterology.2021; 14: 175628482110421.     CrossRef
  • Echoendoscopic ablative therapy for solid pancreatic tumors
    Woo Hyun Paik, Dong Wan Seo
    Journal of Digestive Diseases.2017; 18(3): 135.     CrossRef
  • Endoscopic Ultrasound-Guided Treatment beyond Drainage: Hemostasis, Anastomosis, and Others
    Jessica L. Widmer, Kahaleh Michel
    Clinical Endoscopy.2014; 47(5): 432.     CrossRef
  • Intérêt de l’échographie pour la prise en charge des syndromes douloureux chroniques
    É. J. Viel, J. Lhermite, L. Cherfi
    Douleur et Analgésie.2013; 26(2): 62.     CrossRef
  • Preparation and Patient Evaluation for Safe Gastrointestinal Endoscopy
    Seong Hee Kang, Jong Jin Hyun
    Clinical Endoscopy.2013; 46(3): 212.     CrossRef
  • Imaging pancreatobiliary ductal system with optical coherence tomography: A review
    Mohammad S Mahmud
    World Journal of Gastrointestinal Endoscopy.2013; 5(11): 540.     CrossRef
  • A Case of Left Adrenal Gland Metastatic Cancer Diagnosed by Endoscopic Ultrasound-Guided Fine Needle Aspiration
    Jae Young Oh, Eui Jung Kim, Jung Eun Song, Byung Ho Kim, Hyun-Sik Hwang, Jin Tae Jung, Joong Goo Kwon, Eun Young Kim
    The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2012; 12(3): 202.     CrossRef
  • Introduction; Value of Endoscopic Ultrasound-Guided Fine Needle Aspiration
    Eun Young Kim
    Clinical Endoscopy.2012; 45(2): 115.     CrossRef
  • 6,328 View
  • 47 Download
  • 8 Crossref
Close layer
Cap-assisted ERCP in Surgically Altered Anatomy
Eun Seo Park, M.D., Tae Hoon Lee, M.D., Sang-Heum Park, M.D., Gyu Bong Ko, M.D., Bum Suk Son, M.D., Yun Suk Shim, M.D., Sae Hwan Lee, M.D., Hong-Soo Kim, M.D. and Sun-Joo Kim, M.D.
Korean J Gastrointest Endosc 2010;41(6):344-349.   Published online December 30, 2010
AbstractAbstract PDF
/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is a difficult procedure to perform on patients who have undergone a Billroth II gastrectomy, Whipple's operation or Roux-en-Y gastrobypass surgery. Our study was designed to evaluate the clinical usefulness of cap-assisted ERCP for beginner endoscopists in cases of surgically altered anatomy.
From April 2008 to March 2010, 16 patients with biliary diseases and who had previously undergone abdominal surgery such as Billroth II gastrectomy or Roux-en-Y operation were analyzed. A single endoscopist performed all the procedures using a cap-assisted gastroscope, after ERCP training.
Cap-assisted ERCP was attempted in 24 sessions of 16 patients. Afferent loop intubation and selective bile duct cannulation was successfully achieved in 19 sessions (79.1%). Among the patients who had undergone a Billroth II gastrectomy, 19 out of 20 sessions were successfully conducted. Only 4 patients who had undergone a previous Roux-en-Y operation failed afferent loop intubation. Duodenal free wall perforation developed in one case. There were no cases of mortality.
Therapeutic cap-assisted ERCP was useful in patients who had previously undergone a Billroth II gastrectomy and this may be helpful for inexperienced endoscopists. (Korean J Gastrointest Endosc 2010;41:344-349)
  • 1,770 View
  • 20 Download
Close layer
Magnet Compression Anastomosis for Bilioenteric Anastomotic Stricture after Removal of a Choledochal Cyst: A Case Report
Hyun Chul Lim, M.D., Dong Ki Lee, M.D., Hong Kyu Choi, M.D., Kyo Tae Jung, M.D., Keun Man Lee, M.D., Jae Hoon Jahng, M.D., Joon Sung Park, M.D.* and Jong Yun Won, M.D.
Korean J Gastrointest Endosc 2010;41(3):180-184.   Published online September 30, 2010
AbstractAbstract PDF
Magnet compression anastomosis is a nonsurgical method that uses two magnets to treat bilio-biliary and bilio-enteric anastomotic strictures after a living donor transplantation. The compression pressure of the two magnets induces ischemic necrosis at the anastomostic stricture and creates a fistula at the stricture site. A choledochal cyst is an uncommon congenital anomaly characterized by dilatation of the biliary tree and can cause obstructive jaundice, cholangitis, biliary stones, and cholangiocelluar carcinoma. Treatment for choledochal cyst is essentially surgical including total excision of the cyst with hepaticoenterostomy, but there can be complications such as postoperative intrahepatic stones and recurrent cholangitis due to a stricture at the site of the anastomosis. Endoscopic and fluoroscopy-guided radiologic interventions can be applied to resolve the anastomotic stricture, and re-operation is possible as the method of last resort. We report here a first case, trial magnet compression anastomosis in Korea of a bilioenteric anastomotic stricture after excision of a choledochal cyst and hepaticojejunostomy. (Korean J Gastrointest Endosc 2010;41:180-184)
  • 1,993 View
  • 10 Download
Close layer
Percutaneous Transhepatic Therapy Using Cholangioscopy in Patients with Benign Bilio-Enteric Anastomotic Strictures
Jung-Ho Kim, M.D., Sung-Koo Lee, M.D., Do Hyun Park, M.D., Hyun Kuk Kim, M.D., Sun Young Kim, M.D., Sang Soo Lee, M.D., Dong-Wan Seo, M.D., Myung-Hwan Kim, M.D. and Young-Il Min, M.D.
Korean J Gastrointest Endosc 2003;26(3):133-140.   Published online March 31, 2003
AbstractAbstract PDF
/Aims: Percutaneous transhepatic therapy (PTT) is a non-operative procedure for anastomotic strictures after bilio-enteric anastomosis which cannot be reached via transpapillary route. The aim of this study was to evaluate immediate and long-term results of the PTT using cholangioscopy in patients with benign bilio-enteric anastomotic strictures. Methods: We conducted a retrospective analysis on 22 patients who had undergone PTT for bilio-enteric anastomotic strictures between October 1994 and March 2001. The follow-up duration was 12 to 79 months after PTT (mean 33.0 months). Results: The initial technical success rate was 100%, and the short-term morbidity and mortality rates were 13.5% and 0%, respectively. However, 9 patients developed recurrent strictures (40.9%) with a mean duration of 16.8 months (range: 2 to 38). The success rate without recurrence was 59.1% and the overall success rate was 77.3% when the procedures were repeated. The long term morbidity rate was 36%, but most morbidities resolved with medical treatments. In 18 patients (81.8%), bile duct stones were combined and successfully treated by percutaneous transhepatic cholangioscopy (overall clearance rate: 94.4%, recurrence rate: 39.8%). Conclusions: The PTT using cholangioscopy in patients with benign bilio-enteric anastomotic strictures is a safe and effective method, and it appears a minimally invasive alternative to surgery. (Korean J Gastrointest Endosc 2003;26:133⁣140)
  • 2,041 View
  • 5 Download
Close layer

Close layer