Aug 10, 2005

Endoscopic ultrasound guided therapy of benign and malignant biliary obstruction: a case series

The American Journal of Gastroenterology
Andreas PüspökAlfred Gangl


Endoscopic retrograde cholangiography is an established method for treatment of common bile duct stones as well as for palliation of patients with malignant pancreaticobiliary strictures. It may be unsuccessful in the presence of a complex peripapillary diverticulum, prior surgery, obstructing tumor, papillary stenosis, or impacted stones. Percutaneous transhepatic biliary drainage and surgery are alternative methods with a higher morbidity and mortality in these cases. Recently, endoscopic ultrasound (EUS) guided biliary stent placement has been described in patients with malignant biliary obstruction. We describe our experience with this method that was also used for the treatment of cholangiolithiasis for the first time. The EUS guided transduodenal puncture of the common bile duct with stent placement was performed in 5 patients. In 2 of these patients, the stents were removed after several weeks and common bile duct stones were extracted. In another patient with gastrectomy, the left intrahepatic bile duct was punctured transjejunally and a metal stent was introduced transhepatically to bridge a distal common bile duct stenosis. Biliary decompression was successful in all 6 patients. No immediate complications occurred. On...Continue Reading

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Mentioned in this Paper

Morbidity Aspects
Papillary Stenosis
Impacted Tooth
Biliary Tract Structure
Stent, Device
Malignant Neoplasm of Pancreas
Puncture Procedure
Ultrasonography, Intravascular
Endoscopic Ultrasound

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