Endoscopic and Fluoroscopic Landmarks for Preventing Pyloric Obstruction During Transgastric LAMS Deployment in EUS-Guided Gallbladder Drainage.

Toyonaga and colleagues, with accompanying video, demonstrated that transgastric endoscopic ultrasound-guided gallbladder drainage can be safely performed using a mucosal suction mark and a pyloric clip as endoscopic and fluoroscopic landmarks. This approach enables accurate lumen-apposing metal stent deployment under multimodal guidance while avoiding pyloric ring obstruction.