Endoscopic nasal biliary drainage-guided approach after endoscopic ultrasound-guided hepaticojejunostomy: safe stent exchange technique

Endoscopic ultrasound (EUS)-guided biliary drainage is an alternative when endoscopic retrograde cholangiopancreatography (ERCP) has failed [1] [2]. Covered self-expandable metal stents (CSEMS) or dedicated plastic stents are usually deployed [3] [4]; however, especially when using a transhepatic approach, these stents have a risk of migrating into the abdominal cavity before fistula creation between the hepatic parenchyma and luminal wall....