Use of endoscopic ultrasound-guided gallbladder drainage as a rescue approach in cases of unsuccessful biliary drainage

Figure 1 ERCP failure. A: Case of an infiltrated papilla causing endoscopic retrograde cholangiopancreatography (ERCP) failure; B: Endoscopic ultrasound (EUS)appearance of the dilated CBD (> 15 mm) with a short distance (< 10 mm) between the CBD and the duodenal wall; C: Endoscopic view of the lumen-apposing metal stents (LAMS) correctly placed in the duodenal bulb draining bile; D: Another case. of an infiltrated papilla causing ERCP. failure; E: EUS-BD was unfeasable due to CBD < 15 mm and the distance between the CBD and the duodenal wall > 10 mm; F: Rescue therapy with EUS-GBD was performed with first flange of the LAMS opening in the gallbladder lumen; G: Endoscopic view of the second flange of the LAMS correctly placed in the duodenal bulb.