Jul 4, 2006

Interventional EUS-guided cholangiography: evaluation of a technique in evolution

Gastrointestinal Endoscopy
Michel KahalehPaul Yeaton

Abstract

Interventional EUS-guided cholangiography (IEUC) has been increasingly used as an alternative to percutaneous transhepatic cholangiography (PTC) in cases of biliary obstruction when ERCP is unsuccessful. We reviewed our experience and technique used for this procedure. Over a 3-year period, ending July 2005, patients with a failed ERCP were offered an IEUC. Tertiary care center offering ERCP and interventional EUS. Twenty-eight patients were candidates for IEUC. Two patients had bleeding masses and were referred to interventional radiology, 1 patient had a large mass occupying the duodenal lumen, and 2 patients refused IEUC. EUS was used to access the biliary system after which a guidewire was advanced antegrade across the obstruction. Either rendezvous with retrograde or antegrade drainage was then accomplished. Efficacy and safety of IEUC for biliary decompression. IEUC was successfully performed in 23 patients, with a transgastric-transhepatic (intrahepatic) approach in 13 cases and transenteric-transcholedochal (extrahepatic) approach in 10 cases. Therapeutic benefit was achieved in 21 patients: 18 underwent successful stent deployment across the stricture, whereas 3 patients required a choledochoenteric fistula formation. ...Continue Reading

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  • Citations126

Citations

Mentioned in this Paper

Endoscopy (Procedure)
Yellow Skin or Eyes (Symptom)
Biliary Tract Diseases
Biliary Tract Structure
Structure of Duodenal Lumen
Duodenum
Puncture Procedure
Fluoroscopy
Doppler Studies
Interventional Radiology

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