Subscribe to RSS
DOI: 10.1055/s-2001-17324
© Georg Thieme Verlag Stuttgart · New York
Endoscopic Ultrasound-Guided Bilioduodenal Anastomosis: A New Technique for Biliary Drainage
Publication History
Publication Date:
20 September 2001 (online)
Endoscopic biliary stenting is the most common method of treating obstructive jaundice. We present a new technique of biliary drainage using endoscopic ultrasound (EUS) and EUS-guided puncture of the common bile duct (CBD). A 56-year-old man with obstructive jaundice was referred for EUS and endoscopic retrograde cholangiopancreatography (ERCP) because a computed tomography (CT) scan had shown a pancreatic mass in the head of the pancreas and a dilated CBD. The patient was enrolled in a preoperative chemoradiotherapy protocol and biliary stenting was required. Deep cannulation was not obtained even after a precut and the procedure was stopped. Using a therapeutic EUS scope (FG 38X Pentax), the CBD was punctured with a 5-F needle-knife under EUS guidance and a cholangiogram was obtained. A 0.35-inch guide wire was introduced into the CBD. The EUS scope was removed and a duodenoscope was introduced, allowing the placement through the duodenum of a 10-F plastic stent. The CBD was drained properly. No complication occurred.
References
- 1 Cortas G A, Mehta S N, Abraham N S, Barkun A N. Selective cannulation of the common bile duct: a prospective randomized trial comparing standard catheters with sphincterotomes. Gastrointest Endosc. 1999; 50 775-779
- 2 Ponchon T. Diagnostic endoscopic retrograde cholangiopancreatography. Endoscopy. 2000; 32 200-208
- 3 Schofl R. Diagnostic endoscopic retrograde cholangiopancreatography. Endoscopy. 2001; 33 147-157
- 4 Giovannini M, Seitz J F, Monges G, et al. Fine needle aspiration cytology guided by endoscopic ultrasonography: results in 141 patients. Endoscopy. 1995; 27 17-77
- 5 Vilmann P, Hancke S, Henriksen F W, Jacobsen G K. Endoscopic ultrasonography with fine needle aspiration biopsy in pancreatic disease. Endoscopy. 1993; 25 523-527
- 6 Wegener M, Adamek R J, Wedmann B, Pfaffenbach B. Endosonographically guided fine-needle aspiration puncture of paraesophagogastric mass lesions: preliminary results. Endoscopy. 1994; 26 586-591
- 7 Wieserma M, Vilmann P, Giovannini M, Chang K J. Endosonography-guided fine needle aspiration biopsy: diagnostic accuracy and complication assessment. Gastroenterology. 1997; 112 1087-1095
- 8 Williams D B, Sahai A V, Aabakken L, et al. Endoscopic ultrasound guided fine needle aspiration biopsy: a large single centre experience. Gut. 1999; 44 (5) 720-726
-
9 Wiersema M F.
Endosonography guided celiax plexus neurolysis. In: Bhutani M (ed). Interventional endoscopic ultrasonography. New York; Harwood Academic, 1999: 117-123 - 10 Giovannini M, Bernardini D, Seitz J F. Cystogastrostomy entirely performed under endosonography guidance for pancreatic pseudo-cyst. Gastrointest Endosc. 1998; 48 200-203
- 11 Binmoeller K F, Soehendra N. Endoscopic ultrasonography diagnosis and treatment of pancreatic pseudocysts. Gastrointest Endosc Clin N Am. 1995; 5 805-806
- 12 Wiersema M J. Endosonography-guided cystoduodenostomy with a therapeutic ultrasound endoscope. Gastrointest Endosc. 1996; 44 614-617
- 13 Wiersema M J, Sandusky D, Carr R, Wiersema L, et al. Endosonography-guided cholangiopancreatography. Gastrointest Endosc. 1996; 43 102-106
- 14 Harada N, Kouzu T, Arima M, et al. Endoscopic ultrasound-guided pancreatography: a case report. Endoscopy,. 1995; 27 612-615
M. Giovannini,M.D.
Endoscopy Unit
Paoli-Calmettes Institute
232 Bd Ste-Marguerite
13273 Marseille Cedex 9
France
Fax: + 33-4-91223650
Email: hdjchir@marseille.fnclcc.fr