Bilateral Biliary Drainage for Malignant Hilar Obstruction with EUS-Guided Hepaticogastrostomy and Hepaticoduodenostomy

In a 76-year-old woman with ovarian carcinoma, a large metastatic hilar lesion causedcomplete obstruction of the left and right intrahepatic biliary ducts. She had severe icterus and pruritus, her prior daily function was ECOG level 2. We performed EUS-guided hepaticogastrostomy to drain the left liver lobe. Attempt to bridge the right with the left hepatic ducts through the lesion failed. The right lobe was drained by EUS-guided hepaticoduodenostomy. Five months later, the cancer was stable with tamoxifen and bilirubin normal. This case demonstrates that combined hepaticogastrostomy and hepaticoduodenostomy can achieve complete biliary drainage for malignant hilar obstruction.

Citation: Pham KDC, Engjom HM. OP61V BILATERAL BILIARY DRAINAGE FOR MALIGNANT HILAR OBSTRUCTION WITH EUS-GUIDED HEPATICOGASTROSTOMY AND HEPATICODUODENOSTOMY. Endoscopy 2021; 53: S26.

Publication History

Article published online:
19 March 2021