Endoscopy 2011; 43(9): 826-830
DOI: 10.1055/s-0030-1256406
Case report/series

© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic ultrasound-guided biliodigestive drainage is a good alternative in patients with unresectable cancer

M.  A.  Ramírez-Luna1 , F.  I.  Téllez-Ávila1 , M.  Giovannini2 , F.  Valdovinos-Andraca1 , I.  Guerrero-Hernández1 , J.  Herrera-Esquivel3
  • 1Endoscopy department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México
  • 2Endoscopy Unit, Paoli-Calmettes Institute, Marseille, France
  • 3Endoscopy Department, Hospital General “Manuel Gea Gonzalez”, México City, México
Further Information

Publication History

submitted 26 October 2010

accepted after revision 4 March 2011

Publication Date:
10 August 2011 (online)

A total of 11 prospective cases of endoscopic ultrasound (EUS)-guided cholangio-drainage (EUCD) in patients with end-stage biliopancreatic cancer and biliary tract obstruction are reported. Other available drainage methods (endoscopic retrograde cholangiopancreatography and/or percutaneous transhepatic biliary drainage) of the biliary tract were attempted without success prior to EUS. Technical and clinical success was achieved in 10/11 patients (91 %) and in 9/10 patients (90 %), respectively. Bilirubin decreased by more than 50 % in 7/11 patients (64 %). One patient had a complication that required re-intervention and another patient developed biloma. No mortality directly related to the procedure was documented. In conclusion, EUCD is a good alternative for patients with malignant obstruction of the biliary tract in whom other drainage methods have failed.

References

  • 1 Itoi T, Yamao K. EUS 2008 Working Group document: evaluation of EUS-guided choledochoduodenostomy.  Gastrointest Endosc. 2009;  69 S8-S12
  • 2 Savides T, Varadaajulu S, Palazzo L. EUS 2008 Working Group document: evaluation of EUS-guided hepaticogastrostomy.  Gastrointest Endosc. 2009;  69 S3-S7
  • 3 Levy M. Therapeutic endoscopic ultrasound for biliary and pancreatic disorders.  Curr Gastroenterol Rep. 2010;  12 141-149
  • 4 Wiersema M J, Sandusky D, Carr R et al. Endosonography-guided cholangiopancreatography.  Gastrointest Endosc. 1996;  43 102-106
  • 5 Giovannini M, Moutardier V, Pesenti C et al. Endoscopic ultrasound-guided bilioduodenal anastomosis: a new technique for biliary drainage.  Endoscopy. 2001;  33 898-900
  • 6 Burmester E, Niehaus J, Leineweber T et al. EUS-cholangiodrainage of the bile duct: Report of 4 cases.  Gastrointest Endosc. 2003;  57 246-251
  • 7 Kahaleh M, Yoshida C, Kane L, Yeaton P. Interventional EUS cholangiography: a report of five cases.  Gastrointest Endosc. 2004;  60 138-142
  • 8 Kahaleh M, Hernandez A J, Tokar J et al. Interventional EUS-guided cholangiography: evaluation of a technique in evolution.  Gastrointest Endosc. 2006;  64 52-59
  • 9 Kahaleh M, Wang P, Shami V M et al. EUS-guided transhepatic cholangiography: report of 6 cases.  Gastrointest Endosc. 2005;  61 307-313
  • 10 Bories E, Pesenti C, Caillol F et al. Transgastric endoscopic ultrasonography-guided biliary drainage: results of a pilot study.  Endoscopy. 2007;  39 287-291
  • 11 Maranki J, Hernandez A J, Arslan B et al. Interventional endoscopic ultrasound-guided cholangiography: long-term experience of an emerging alternative to percutaneous transhepatic cholangiography.  Endoscopy. 2009;  41 532-538
  • 12 Puspok A, Lomoschitz F, Dejaco C et al. Endoscopic ultrasound guided therapy of benign and malignant biliary obstruction: a case series.  Am J Gastroenterol. 2005;  100 1743-1747
  • 13 Will U, Thieme A, Fueldner F et al. Treatment of biliary obstruction in selected patients by endoscopic ultrasonography (EUS)-guided transluminal biliary drainage.  Endoscopy. 2007;  39 292-295
  • 14 Yamao K, Bhatia V, Mizuno N et al. EUS-guided choledochoduodenostomy for palliative biliary drainage in patients with malignant biliary obstruction: results of long-term follow-up.  Endoscopy. 2008;  40 340-342
  • 15 Brauer B C, Chen Y K, Fukami N, Shah R J. Single-operator EUS-guided cholangiopancreatography for difficult pancreaticobiliary access (with video).  Gastrointest Endosc. 2009;  70 471-479
  • 16 Yamao K, Sawaki A, Takahashi K et al. EUS-guided choledochoduodenostomy for palliative biliary drainage in case of papillary obstruction: report of 2 cases.  Gastrointest Endosc. 2006;  64 663-667
  • 17 Ang T L, Teo E K, Fock K M. EUS-guided transduodenal biliary drainage in unresectable pancreatic cancer with obstructive jaundice.  JOP. 2007;  8 438-443
  • 18 Fujita N, Noda Y, Kobayashi G et al. Histological changes at an endosonography-guided biliary drainage site: a case report.  World J Gastroenterol. 2007;  13 5512-5515
  • 19 Tarantino I, Barresi L, Repici A, Traina M. EUS-guided biliary drainage: a case series.  Endoscopy. 2008;  40 336-339
  • 20 Itoi T, Itokawa F, Sofuni A et al. Endoscopic ultrasound-guided choledochoduodenostomy in patients with failed endoscopic retrograde cholangiopancreatography.  World J Gastroenterol. 2008;  14 6078-6082
  • 21 Hanada K, Iiboshi T, Ishii Y. Endoscopic ultrasound-guided choledochoduodenostomy for palliative biliary drainage in cases with inoperable pancreas head carcinoma.  Dig Endosc. 2009;  21 (Suppl. 1) S75-S78
  • 22 Park do H, Koo J E, Oh J et al. EUS-guided biliary drainage with one-step placement of a fully covered metal stent for malignant biliary obstruction: a prospective feasibility study.  Am J Gastroenterol. 2009;  104 2168-2174
  • 23 Artifon E L, Chaves D M, Ishioka S et al. Echoguided hepatico-gastrostomy: a case report.  Clinics (Sao Paulo). 2007;  62 799-802

M. A. Ramírez-LunaMD 

Endoscopy Department
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

Vasco de Quiroga #15
Col. Sección XVI Del. Tlalpan
C.P. 14000
Mexico City
Mexico

Fax: +52-55-4870900

Email: mangelramirez@yahoo.com