Endoscopic ultrasound-guided choledochoduodenostomy: How i do it

Kazuo Hara, Kenji Yamao, Nobumasa Mizuno, Akira Sawaki, Tadayuki Takagi, Vikram Bhatia

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

Abstract

Endoscopic biliary drainage (EBD) may be unsuccessful in some patients, because of failed biliary cannulation or tumor infiltration, limiting endoscopic access to major papilla. The alternative method of percutaneous transhepatic biliary drainage carries a risk of complications, such as bleeding, portal vein thrombus, portal vein occlusion and intra- or extra-abdominal bile leakage. Recently, endoscopic ultrasonography (EUS)-guided biliary stent placement has been described in patients with malignant biliary obstruction. Technically, EUS-guided biliary drainage is possible via transgastric or transduodenal routes or through the small intestine using a direct access or rendezvous technique. We describe herein a technique for direct stent insertion from the duodenal bulb for the management of patients with jaundice caused by malignant obstruction of the lower extrahepatic bile duct. We think transduodenal direct access is the best treatment in patients with jaundice caused by inoperable malignant obstruction of the lower extrahepatic bile duct when EBD fails.

Original languageEnglish
Pages (from-to)147-150
Number of pages4
JournalDigestive Endoscopy
Volume22
Issue number2
DOIs
Publication statusPublished - 01-04-2010
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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