Fig. 4. The standard technique of endoscopic ultrasound-guided transmural drainage. (A) Puncture. (B) Aspirated fluid. (C) Contrast injection. (D) Guidewire insertion. (E) Fistula tract dilatation. (F) Insertion of a metal stent. (G) Unfolding of the distal flange of the lumen-apposing metal stent (LAMS) (Niti-S SPAXUS stent; TaeWoong Medical Co., Ltd., Ilsan, Korea). (H) An endoscopic image of a LAMS. (I) A fluoroscopic image of a LAMS.
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