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Endoscopy 1978; 10(3): 203-206
DOI: 10.1055/s-0028-1098295
Reports of New Instruments and Methods

© Georg Thieme Verlag, Stuttgart

Endoscopic Retrograde Cholangiography (ERC) through Artificial Endoscopic Choledocho-Duodenal Fistula

Endoskopisch retrograde Cholangiographie (ERC) durch eine artefizielle endoskopisch geschaffene CholedochusduodenumfistelG. C. Caletti, A. Vandelli, L. Bolondi, G. Fontana, G. Labò
  • Istituto di Clinica Medica e Gastroenterologia, Università di Bologna, Italy
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Publication History

Publication Date:
08 December 2008 (online)

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Summary

A new endoscopic method for retrograde cholangiography in cases of unsuccessful cannulation of the papilla is described. In 1 patient with obstructive jaundice, severe diabetes and a previous history of biliary pain traditional ERC failed. An endoscopic artificial choledocho-duodenal fistula by means of a diathermic cutter (needle type) was performed at the lower end of the intramural portion of the common bile duct for retrograde cholangiography. X-ray showed an obstruction of the common bile duct due to a carcinoma of the head of the pancreas. Complications did not occur during the procedure and in the post-operative period. It is concluded that the described method may be helpful when traditional selective ERC fails, moreover it may permit an endoscopic choledocho-duodenostomy for choledocholithiasis in cases of unsuccessful endoscopic papillosphincterotomy.

Zusammenfassung

Es wird ein neues endoskopisches Verfahren der retrograden Cholangiographie bet erfolgloser Kanülierung der Vaterschen Papille vorgestellt. Bei einem Patienten mit Verschlußikterus, schwerem Diabetes und vorausgegangenen Gallenkoliken gelang eine retrograde Cholangiographie primär nicht. Durch eine endoskopisch geschaffene Fistel zwischen Duodenum und Gallengang unter Verwendung eines nadelförmigen Diathermiegeräts gelang die retrograde Cholangiographie schließlich, die eine Gallengangsobstruktion durch ein Pankreaskopfkarzinom ergab. Komplikationen wurden nicht beobachtet.

Key-Words

Endoscopic retrograde cholangiopancreatography (ERCP) - endoscopic cannulation - choledocho-duodenal fistula - endoscopic choledocho-duodenostomy - percutaneous transhepatic cholangiography (PTC) - endoscopic papillosphincterotomy (EPT)