Five patients with obstructive jaundice caused by malignant periampullary biliary
stenosis underwent EUS-guided choledochoduodenostomy (EUS-CDS) from the first portion
of the duodenum using a convex echoendoscope and a needle knife. All the steps of
the procedure including passage dilatation and the plastic stent placement were performed
through the accessory channel of the echoendoscope over the guide wire. Stent insertion
was technically successful in all five patients. The procedure was also clinically
effective in relieving jaundice in all cases. One patient developed pneumoperitoneum,
which resolved with conservative management. Stent exchange was successful in seven
of eight attempts in patients with stent occlusion. One failure was due to tumor invasion
to the choledochoduodenal fistula. Stent patency was maintained in the remaining patients
throughout their survival period. The average stent patency was 211.8 days. EUS-CDS
from the first portion of the duodenum appears to be feasible and safe in cases of
obstructive jaundice caused by distal bile duct obstruction.
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CD004200
K. Yamao, MD
Department of Gastroenterology
Aichi Cancer Center Hospital
1-1 Kanokoden
Chikusa-ku
Nagoya 464-8681
Japan
Fax: + 81-52-7635233
Email: kyamao@aichi-cc.jp
