Crisscross anchor-stents to prevent metal stent migration during endoscopic ultrasound-guided hepaticogastrostomy.

Fig.2 An endoscopic retrograde cholangiopancreatography (ERCP) cannula was used to puncture the mesh wall of the covered self-expandable metal stent (SEMS). A guidewire was then passed through the mesh wall and the opposite wall of the metal stent. Fig.1 A covered self-expandable metal stent (SEMS) used for endoscopic ultrasoundguided hepaticogastrostomy (EUS-HGS) had nearly migrated into the peritoneal cavity of an 82-year-old man as a result of interference between the percutaneous transhepatic biliary drainage catheter and the SEMS.The distal end of the stent could barely be seen.