Endoscopic retrograde cholangiography (ERC) can be technically challenging in patients with surgically altered gastrointestinal anatomy (SAGA). Historically, patients with SAGA have required device-assisted enteroscopy, percutaneous transhepatic biliary drainage, or invasive surgical procedures for management of biliary disease. EUS-guided hepaticogastrostomy (EUS-HG) is a novel endoscopic technique that provides alternate access to the biliary tree.
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Pawa et al. (2021) studied this question.