Conversion of percutaneous transhepatic gallbladder drainage to endoscopic ultrasound‐guided hepaticogastrostomy by the intentional expansion method.

In cases of malignant obstructive cholangitis with surgically altered gastrointestinal anatomy, if the intra-hepatic bile duct is not expanded, both percutaneous transhepatic biliary drainage (PTBD) and endoscopic ultrasound (EUS)-guided biliary drainage are difficult to perform.[[1]] In such case, percutaneous transhepatic gallbladder drainage (PTGBD) become a good indication. We report a successful case of conversion from PTGBD to EUS-guided hepaticogastrostomy (EUS-HGS) with intentional expansion of the intra-hepatic bile duct by contrast injection through the PTGBD route.[[3]] The continuous contrast medium injection form PTGBD route, the gallbladder and intra-hepatic bile duct were expanded. [Extracted from the article]