Abstract
Introduction: Endoscopic retrograde cholangiopancreatography is the method of choice for biliary drainage, although in some cases standard biliary access is difficult or even impossible. Endoscopic ultrasound (EUS)-guided endoluminal procedures are an alternative in these cases, although experience with these techniques is still limited. Clinical Case: We present two cases of successful EUS-guided biliary drainage. In the first case, a hepaticogastrostomy was performed in a patient with stage IV gastric adenocarcinoma with obstructive jaundice due to compression of the hilum, where malignant gastric stenosis and previous palliative gastrojejunostomy precluded access to the second part of the duodenum. In the second case, a patient with a pancreatic head adenocarcinoma with duodenal invasion that precluded major papillae identification was submitted to a choledochoduodenostomy. Both procedures occurred without immediate or delayed adverse events, with technical and clinical success. Discussion: Although experience with EUS-guided biliary drainage is still limited, its efficacy and safety is favorable when compared with percutaneous and surgical drainage, and should be considered an alternative to these techniques where sufficient expertise exists.
| Original language | English |
|---|---|
| Pages (from-to) | 258-263 |
| Number of pages | 5 |
| Journal | GE Portuguese Journal of Gastroenterology |
| Early online date | 20 Dec 2017 |
| DOIs | |
| Publication status | Published - 1 Sep 2018 |
Fingerprint
Keywords
- Biliary drainage
- Endoscopic retrograde cholangiopancreatography
- Endoscopic ultrasonography
- Gastrointestinal cancer
- Palliative therapy
Cite this
}
Endoscopic Ultrasound-Guided Biliary Drainage in Two Patients with Difficult Biliary Access. / Libânio, Diogo; Giestas, Sílvia; Martinez-Ares, David; Ferreira, Frederico; Canena, Jorge; Certo, Manuela; Lopes, Luís.
In: GE Portuguese Journal of Gastroenterology, 01.09.2018, p. 258-263.Research output: Contribution to journal › Article
TY - JOUR
T1 - Endoscopic Ultrasound-Guided Biliary Drainage in Two Patients with Difficult Biliary Access
AU - Libânio, Diogo
AU - Giestas, Sílvia
AU - Martinez-Ares, David
AU - Ferreira, Frederico
AU - Canena, Jorge
AU - Certo, Manuela
AU - Lopes, Luís
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Introduction: Endoscopic retrograde cholangiopancreatography is the method of choice for biliary drainage, although in some cases standard biliary access is difficult or even impossible. Endoscopic ultrasound (EUS)-guided endoluminal procedures are an alternative in these cases, although experience with these techniques is still limited. Clinical Case: We present two cases of successful EUS-guided biliary drainage. In the first case, a hepaticogastrostomy was performed in a patient with stage IV gastric adenocarcinoma with obstructive jaundice due to compression of the hilum, where malignant gastric stenosis and previous palliative gastrojejunostomy precluded access to the second part of the duodenum. In the second case, a patient with a pancreatic head adenocarcinoma with duodenal invasion that precluded major papillae identification was submitted to a choledochoduodenostomy. Both procedures occurred without immediate or delayed adverse events, with technical and clinical success. Discussion: Although experience with EUS-guided biliary drainage is still limited, its efficacy and safety is favorable when compared with percutaneous and surgical drainage, and should be considered an alternative to these techniques where sufficient expertise exists.
AB - Introduction: Endoscopic retrograde cholangiopancreatography is the method of choice for biliary drainage, although in some cases standard biliary access is difficult or even impossible. Endoscopic ultrasound (EUS)-guided endoluminal procedures are an alternative in these cases, although experience with these techniques is still limited. Clinical Case: We present two cases of successful EUS-guided biliary drainage. In the first case, a hepaticogastrostomy was performed in a patient with stage IV gastric adenocarcinoma with obstructive jaundice due to compression of the hilum, where malignant gastric stenosis and previous palliative gastrojejunostomy precluded access to the second part of the duodenum. In the second case, a patient with a pancreatic head adenocarcinoma with duodenal invasion that precluded major papillae identification was submitted to a choledochoduodenostomy. Both procedures occurred without immediate or delayed adverse events, with technical and clinical success. Discussion: Although experience with EUS-guided biliary drainage is still limited, its efficacy and safety is favorable when compared with percutaneous and surgical drainage, and should be considered an alternative to these techniques where sufficient expertise exists.
KW - Biliary drainage
KW - Endoscopic retrograde cholangiopancreatography
KW - Endoscopic ultrasonography
KW - Gastrointestinal cancer
KW - Palliative therapy
UR - http://www.scopus.com/inward/record.url?scp=85038628991&partnerID=8YFLogxK
U2 - 10.1159/000485429
DO - 10.1159/000485429
M3 - Article
SP - 258
EP - 263
JO - GE Portuguese Journal of Gastroenterology
JF - GE Portuguese Journal of Gastroenterology
SN - 2341-4545
ER -