Fig. 2. Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS) using a 7-Fr double-pigtail plastic stent (DPPS) for obstruction of the left intrahepatic duct (IHD). (A) After failed cannulation to the left IHD, a dilated left IHD was observed on the expected needle track for EUS-HGS. (B, C) The left IHD (B3) was punctured by a 19-gauge standard needle. (D) The fistula tract was dilated using a 4-mm balloon catheter. (E) Fluoroscopic image showing the 7-Fr DPPS placed between the stomach and the left IHD. (F) Endoscopic image showing the drainage of pus-like material through the 7-Fr DPPS.
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