Endoscopic ultrasound-guided biliary drainage for right hepatic bile duct obstruction: novel technical tips

Takeshi Ogura; Tatsushi Sano; Saori Onda; Akira Imoto; Daisuke Masuda; Kazuhiro Yamamoto; Masayuki Kitano; Toshihisa Takeuchi; Takuya Inoue; Kazuhide Higuchi

doi:10.1055/s-0034-1378111

Endoscopy, Table of Contents

Endoscopy 2015; 47(01): 72-75
DOI: 10.1055/s-0034-1378111

Case series

Endoscopic ultrasound-guided biliary drainage for right hepatic bile duct obstruction: novel technical tips

Takeshi Ogura

¹2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan

,

Tatsushi Sano

¹2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan

,

Saori Onda

¹2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan

,

Akira Imoto

¹2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan

,

Daisuke Masuda

¹2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan

,

Kazuhiro Yamamoto

²Department of Radiology, Osaka Medical College, Osaka, Japan

,

Masayuki Kitano

³Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan

,

Toshihisa Takeuchi

¹2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan

,

Takuya Inoue

¹2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan

,

Kazuhide Higuchi

¹2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan

› Author Affiliations

Abstract

Endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) is not normally indicated for an obstructed right intrahepatic bile duct (IHBD). The technical feasibility and clinical efficacy of a novel technique of EUS-BD for right IHBD obstruction were evaluated. A total of 11 patients underwent drainage using either a left or a right biliary access route. The causes of obstructive jaundice were cholangiocarcinoma (n = 6), pancreatic cancer (n = 3), gastric cancer (n = 1), and colon cancer (n = 1). After placement of an uncovered metal stent to bridge the obstruction, a hepaticogastrostomy was completed using a covered stent. Mean procedure time was 33.9 ± 10.0 minutes. Technical and functional success were achieved in all patients, and no adverse events occurred. This novel method appears to be safe and effective for right IHBD obstruction.

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References

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