May 3, 2013

Endoscopic ultrasonography-guided cholecystogastrostomy using a lumen-apposing metal stent as an alternative to extrahepatic bile duct drainage in pancreatic cancer with duodenal invasion

Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society
Takao ItoiReina Tanaka


Various approaches to biliary drainage, especially endoscopic ultrasonography (EUS)-guided drainage, have become commonly used as an alternative method for biliary decompression for malignant biliary obstruction. Occasionally, however, duodenal obstruction and non-dilated intrahepatic bile duct impede conventional EUS-guided biliary drainage. Herein, we describe a case of cholecystogastrostomy successfully carried out using a newly developed fully covered lumen-apposing self-expandable metallic stent (SEMS). EUS-guided cholecystogastrostomy should be considered an option for biliary decompression. This is a particularly ideal alternative if the patient has duodenal strictures with or without a duodenal metal stent and a non-dilated intrahepatic bile duct, which suggests the impossibility of choledochoduodenostomy and hepaticogastrostomy. Furthermore, the newly developed fully covered lumen-apposing SEMS seems ideal for EUS-guided cholecystoenterostomy.

  • References6
  • Citations12

Mentioned in this Paper

Entire Lumen of Body System
Pancreatic Carcinoma
Stent, Device
Malignant Neoplasm of Pancreas
Duodenal Cancer
Duodenal Obstruction
Malignant Tumor of Extrahepatic Bile Duct
Endoscopic Ultrasound
Malignant Paraganglionic Neoplasm

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