In “hot” pursuit of an evasive gallbladder

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In “hot” pursuit of an evasive gallbladder Lady Katherine Mejía Pérez, MD, Bhaumik Brahmbhatt, MBBS, Victoria Gómez, MD VideoGIE Volume 2, Issue 10, Pages 264-265 (October 2017) DOI: 10.1016/j.vgie.2017.06.001 Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 A, Preprocedural sinogram revealing opacification of the patent common bile duct with contrast material emptying into the duodenum. B, CT scan revealing gallbladder stones (arrowhead) and a cirrhotic liver (arrow). C, EUS view revealing a percutaneous cholecystostomy drain (arrow) in a distended gallbladder (arrowheads) with normal saline solution in its interior (bubbles). D, EUS view demonstrating the 19-gauge needle puncturing the gallbladder from the duodenum. E, Fluoroscopic view showing 19-gauge needle (arrowhead) and contrast material in the gallbladder (arrow). F, Fluoroscopic view revealing 3 loops of a 0.035-inch guidewire within the gallbladder (arrow). G, EUS view showing fully deployed distal flange of the stent (arrow) within the gallbladder. H, Endoscopic view showing the proximal flange of the lumen-apposing metal stent (LAMS) deployed in the duodenal bulb (arrow). Bile can be appreciated flowing through the catheter (arrowhead). I, Fluoroscopic view revealing contrast material flowing through the percutaneous cholecystostomy tube into the gallbladder and into the duodenum, further confirming adequate stent placement. VideoGIE 2017 2, 264-265DOI: (10.1016/j.vgie.2017.06.001) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions