Abstract
Background: This report describes a novel application of EUS-guided cholangiography in which a transhepatic approach was used to alleviate perihilar and distal biliary obstructions when this could not be accomplished at ERCP. Methods: EUS-guided transhepatic cholangiography was used to alleviate symptoms of biliary obstruction in 6 patients. In 4 cases, after transgastric puncture of an intrahepatic branch of the obstructed bile duct with a 19- or a 22-gauge EUS needle, a guidewire was advanced antegrade across both the biliary stricture and the papilla. Subsequently, a rendezvous procedure was performed, allowing ERCP and stent placement. Observations: EUS-guided transhepatic cholangiography was performed in 6 patients, with successful rendezvous ERCP and stent placement in 4, and transduodenal stent placement in another patient. Stent placement was unsuccessful in one patient, because of the inability to advance a guidewire into the common hepatic duct. There was no immediate complication of the procedures. Conclusions: EUS-guided transhepatic cholangiography can be used to access and to drain bile ducts that are obstructed by proximal, as well as distal lesions when ERCP is unsuccessful.
Original language | English (US) |
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Pages (from-to) | 307-313 |
Number of pages | 7 |
Journal | Gastrointestinal Endoscopy |
Volume | 61 |
Issue number | 2 |
DOIs | |
State | Published - Feb 2005 |
Externally published | Yes |
All Science Journal Classification (ASJC) codes
- Radiology Nuclear Medicine and imaging
- Gastroenterology