EUS-Guided Antegrade Transhepatic Placement of a Self-Expandable Metal Stent in Hepatico-Jejunal Anastomosis
Abstract
Context To demonstrate an EUS-guided biliary drainage in patient with gastrointestinal tract modified surgically. Case report An EUS guided access to the left intra hepatic duct, followed by an antegrade passage of a partially self-expandable metal stent that was removed by using an enteroscope, in one patient with hepatico-jejunal anastomosis. There were no early or delayed complications and the procedure was effective in relieving jaundice until the self-expandable metal stent was removed, 3 months later. A cholangiogram was obtained via enteroscopy, after removal of self-expandable metal stent, and found to be normal. The patient had an uneventful evaluation afterwards. Conclusion The indication of these procedures must be made under a multidisciplinary view while sharing information with the patient or legal guardian. EUS-guided biliary drainage is feasible when performed by professionals with expertise in biliopancreatic endoscopy and advanced echo-endoscopy and should be performed currently under rigorous protocol in educational institutions.
Downloads
References
Artifon EL, Takada J, Okawa L, Moura EG, Sakai P. EUS-guided choledochoduodenostomy for biliary drainage in unresectable pancreatic cancer: a case series. JOP. J Pancreas (Online) 2010; 11:597-600. [PMID 21068493]
Kahaleh M, Hernandez AJ, Tokar J, Adams RB, Shami VM, Yeaton P. Interventional EUS-guided cholangiography: evaluation of a technique in evolution. Gastrointest Endosc 2006; 64:52-9. [PMID 16813803]
Kahaleh M, Behm B, Clarke BW, Brock A, Shami VM, De La Rue SA, et al. Temporary placement of covered self-expandable metal stents in benign biliary strictures: a new paradigm? (with video). Gastrointest Endosc 2008; 67:446-54. [PMID 18294506]
Becker CD, Glättli A, Maibach R, Baer HU. Percutaneous palliation of malignant obstructive jaundice with the Wallstent endoprosthesis: follow-up and reintervention in patients with hilar and non-hilar obstruction. J Vasc Interv Radiol 1993; 4:597-604. [PMID 7693074]
Savides TJ, Varadarajulu S, Palazzo L, EUS 2008 Working Group. EUS 2008 Working Group document: evaluation of EUS-guided hepaticogastrostomy. Gastrointest Endosc 2009; 69:S3-7. [PMID 19179166]
Nguyen-Tang T, Binmoeller KF, Sanchez-Yague A, Shah JN. Endoscopic ultrasound (EUS)-guided transhepatic anterograde self-expandable metal stent (SEMS) placement across malignant biliary obstruction. Endoscopy 2010; 42:232-6. [PMID 20119894]
Itoi T, Yamao K. EUS 2008 Working Group document: evaluation of EUS-guided choledochoduodenostomy (with video). Gastrointest Endosc 2009; 69:S8-12. [PMID 19179177]
Maranki J, Hernandez AJ, Arslan B, Jaffan AA, Angle JF, Shami VM, Kahaleh M. Interventional endoscopic ultrasound-guided cholangiography: long-term experience of an emerging alternative to percutaneous transhepatic cholangiography. Endoscopy 2009; 41:532-8. [PMID 19533558]
Copyright (c) 2014 Everson L A Artifon, Adriana Vaz Safatle-Ribeiro, Flávio Coelho Ferreira, Luiz Poli-de-Figueiredo, Samir Rasslan, Francisco Carnevale, José Pinhata Otoch, Paulo Sakai, Michel Kahaleh
This work is licensed under a Creative Commons Attribution 4.0 International License.
As a member of Publisher International Linking Association, PILA, iMedPub Group’s JOP follows the Creative Commons Attribution License and Scholars Open Access publishing policies. Journal of the Pancreas is the Council Contributor Member of Council of Science Editors (CSE) and following the CSE slogan Education, Ethics, and Evidence for Editors.