AIM:To further reduce the risk of bleeding or bile leakage.METHODS:We performed endoscopic ultrasound guided biliary drainage in 6 patients in whom endoscopic retrograde cholangiopancreatography(ERCP) had failed.Bilia...AIM:To further reduce the risk of bleeding or bile leakage.METHODS:We performed endoscopic ultrasound guided biliary drainage in 6 patients in whom endoscopic retrograde cholangiopancreatography(ERCP) had failed.Biliary access of a dilated segment 2 or 3 duct was achieved from the stomach using a 19G needle.After radiologically confirming access a guide wire was placed,a transhepatic tract created using a 6 Fr cystotome followed by balloon dilation of the stricture and antegrade metallic stent placement across the malignant obstruction.This was followed by placement of an endocoil in the transhepatic tract.RESULTS:Dilated segmental ducts were observed in all patients with the linear endoscopic ultrasound scope from the proximal stomach.Transgastric biliary access was obtained using a 19G needle in all patients.Biliary drainage was achieved in all patients.Placement of an endocoil was possible in 5/6 patients.All patients responded to biliary drainage and no complications occurred.CONCLUSION:We show that placing endocoils at the time of endoscopic ultrasound guided biliary stenting is feasible and may reduce the risk of bleeding or bile leakage.展开更多
文摘AIM:To further reduce the risk of bleeding or bile leakage.METHODS:We performed endoscopic ultrasound guided biliary drainage in 6 patients in whom endoscopic retrograde cholangiopancreatography(ERCP) had failed.Biliary access of a dilated segment 2 or 3 duct was achieved from the stomach using a 19G needle.After radiologically confirming access a guide wire was placed,a transhepatic tract created using a 6 Fr cystotome followed by balloon dilation of the stricture and antegrade metallic stent placement across the malignant obstruction.This was followed by placement of an endocoil in the transhepatic tract.RESULTS:Dilated segmental ducts were observed in all patients with the linear endoscopic ultrasound scope from the proximal stomach.Transgastric biliary access was obtained using a 19G needle in all patients.Biliary drainage was achieved in all patients.Placement of an endocoil was possible in 5/6 patients.All patients responded to biliary drainage and no complications occurred.CONCLUSION:We show that placing endocoils at the time of endoscopic ultrasound guided biliary stenting is feasible and may reduce the risk of bleeding or bile leakage.
