Mar 31, 2011

Prospective clinical study of EUS-guided choledochoduodenostomy for malignant lower biliary tract obstruction

The American Journal of Gastroenterology
Kazuo HaraHidemi Goto

Abstract

Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) has recently been reported as an alternative to percutaneous transhepatic biliary drainage (PTBD) in cases of biliary obstruction, when endoscopic biliary drainage (EBD) is unsuccessful. However, prospective studies of EUS-CDS have not yet been performed. We conducted a prospective study to evaluate the safety, feasibility, and efficacy of EUS-CDS in patients with malignant lower biliary tract obstruction. A prospective study to confirm the safety of EUS-CDS was carried out in 6 patients, followed by a trial to evaluate the feasibility and efficacy of EUS-CDS in 12 additional patients. We placed a plastic stent from the duodenal bulb into the extrahepatic bile duct under EUS guidance using an oblique viewing echoendoscope, needle knife, guidewire, and biliary dilators. The site of extrahepatic bile duct puncture was the common hepatic duct in 15 patients and the common bile duct in 3 patients. Mean diameter of the punctured extrahepatic bile ducts was 10 mm (range: 6-20 mm). Technical and functional success rates were 94% (17/18) and 100% (17/17), respectively. Median procedure time was 30 min (range: 10-52 min). Median duration to first oral intake after the procedu...Continue Reading

  • References16
  • Citations31

References

  • References16
  • Citations31

Citations

Mentioned in this Paper

Endoscopy (Procedure)
perfluoro-2,2,2',2'-tetramethyl-4,4'-bis(1,3-dioxolane)
Biliary Tract Diseases
Entire Duodenal Cap
Choledochostomy
Biliary Atresia
Uterine Cancer
Benign Neoplasm of Extrahepatic Bile Ducts
Stent, Device
Malignant Neoplasm of Pancreas

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