Endoscopy 2008; 40(4): 340-342
DOI: 10.1055/s-2007-995485
Case report

© Georg Thieme Verlag KG Stuttgart · New York

EUS-guided choledochoduodenostomy for palliative biliary drainage in patients with malignant biliary obstruction: Results of long-term follow-up

K.  Yamao1 , V.  Bhatia2 , N.  Mizuno1 , A.  Sawaki1 , H.  Ishikawa1 , M.  Tajika1 , N.  Hoki1 , Y.  Shimizu3 , R.  Ashida4 , N.  Fukami5
  • 1Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
  • 2Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
  • 3Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Japan
  • 4Division of Gastroenterology, University of California, Irvine Medical Center, Orange, USA
  • 5Division of Gastroenterology and Hepatology, University of Colorado at Denver and Health Sciences Center, Denver, USA
Further Information

Publication History

submitted 3 October 2007

accepted after revision 6 December 2007

Publication Date:
04 April 2008 (online)

Five patients with obstructive jaundice caused by malignant periampullary biliary stenosis underwent EUS-guided choledochoduodenostomy (EUS-CDS) from the first portion of the duodenum using a convex echoendoscope and a needle knife. All the steps of the procedure including passage dilatation and the plastic stent placement were performed through the accessory channel of the echoendoscope over the guide wire. Stent insertion was technically successful in all five patients. The procedure was also clinically effective in relieving jaundice in all cases. One patient developed pneumoperitoneum, which resolved with conservative management. Stent exchange was successful in seven of eight attempts in patients with stent occlusion. One failure was due to tumor invasion to the choledochoduodenal fistula. Stent patency was maintained in the remaining patients throughout their survival period. The average stent patency was 211.8 days. EUS-CDS from the first portion of the duodenum appears to be feasible and safe in cases of obstructive jaundice caused by distal bile duct obstruction.

References

K. Yamao, MD

Department of Gastroenterology

Aichi Cancer Center Hospital

1-1 Kanokoden

Chikusa-ku

Nagoya 464-8681

Japan

Fax: + 81-52-7635233

Email: [email protected]