Fig. 4. Endoscopic ultrasound-guided hepaticogastrostomy in patients with surgically altered anatomy (SAA), which is responsible for failure of single-balloon enteroscope assisted endoscopic retrograde cholangiopancreatography. (A) It was impossible to reach the target site due to tumor invasion of the duodenum. (B) Endoscopic ultrasound-guided biliary drainage was performed with a B3 puncture to obtain a cholangiogram. (C, D) A biliary stent was successfully placed.
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