Transduodenal Endosonography-Guided Biliary Drainage and Duodenal Stenting for Palliation of Malignant Obstructive Jaundice and Duodenal Obstruction

  • Fauze Maluf-Filho Cancer Institute of São Paulo University Medical School (ICESP). São Paulo, SP, Brazil
  • Felipe Alves Retes Cancer Institute of São Paulo University Medical School (ICESP). São Paulo, SP, Brazil
  • Carla Zanellato Neves Cancer Institute of São Paulo University Medical School (ICESP). São Paulo, SP, Brazil
  • Cezar Fabiano Manabu Sato Cancer Institute of São Paulo University Medical School (ICESP). São Paulo, SP, Brazil
  • Fabio Shiguehissa Kawaguti Cancer Institute of São Paulo University Medical School (ICESP). São Paulo, SP, Brazil
  • Ricardo Jureidini Cancer Institute of São Paulo University Medical School (ICESP). São Paulo, SP, Brazil
  • Ulysses Ribeiro Jr Cancer Institute of São Paulo University Medical School (ICESP). São Paulo, SP, Brazil
  • Telesforo Bacchella Cancer Institute of São Paulo University Medical School (ICESP). São Paulo, SP, Brazil
Keywords: Bile Ducts /ultrasonography, Drainage /adverse effects /methods, Duodenal Obstruction, Endosonography, Gastric Outlet Obstruction, Jaundice, Obstructive

Abstract

Context Endosonography-guided biliary drainage has been used over the last few years as a salvage procedure when endoscopic retrograde cholangiopancreatography fails. Malignant gastric outlet obstruction may also be present in these patients. We report the results of both procedures during the same session in patients with duodenal and biliary obstruction due to malignant disease. Methods A retrospective review from a prospective collected database. Results Technical success was achieved in all five patients; however, only three patients experienced relief of jaundice and gastric outlet obstruction. Conclusions Endosonography-guided biliary drainage and duodenal stenting in the same session is feasible. However, severe complications may limit the procedure. This is a challenging procedure and should be done by experts with special attention to patient’s selection.

Downloads

Download data is not yet available.

References

Stern N, Sturgess R. Endoscopic therapy in the management of malignant biliary obstruction. Eur J SurgOncol2008; 34(3):313-317 [PMID 18276101]

Cipolletta L, Rotondano G, Marmo R, Bianco MA. Endoscopic palliation of malignant obstructive jaundice: an evidence-based review. Dig Liver Dis 2007; 39(4):375-88 [PMID 17317347]

Winick AB, Waybill PN, Venbrux AC. Complications of percutaneous transhepatic biliary interventions. Tech Vasc Interv Radiol 2001; 4(3):200-6 [PMID 11748558]

Perez-Miranda M, Serna C, Diez-Redondo P, Vila JJ. Endosonography-guided cholangiopancreatography as a salvage drainage procedure for obstructed biliary and pancreatic ducts. World J GastrointestEndosc2010; 2(6):212-222 [PMID 21160936]

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; 64:53-9 [PMID 16813803]

Giovannini M, Moutardier V, Pesenti C, Bories E, Lelong B, Delpero JR. Endoscopic ultrasound-guided bilioduodenal anastomosis: a new technique for biliary drainage. Endoscopy 2001; 33(10):898-900 [PMID 11571690]

Itoi T, Itokawa F, Sofuni A, Kurihara T, Tsuchiya T, Ishii, et al. Endoscopic ultrasound-guided choledochoduodenostomy in patients with failed endoscopic retrograde cholangiopancreatography. World J Gastroenterol 2008; 14(39):6078-82 [PMID 18932289]

Yamao K, Bhatia V, Mizuno N, SawakiA, Ishikawa H, Tajika M, et al. EUS-guided choledochoduodenostomy for palliative biliary drainage in patients with malignant biliary obstruction: results of long-term follow-up. Endoscopy 2008; 40:340-2 [PMID 18389451]

Giovannini M, Dotti M, Bories E, Moutardoer V, Pesenti C, Danisi C, Delpero JR. Hepaticogastrostomy by echo-endoscopy as a palliative treatment in a patient with metastatic biliary obstruction. Endoscopy 2003; 35:1076-8 [PMID 14648424]

Artifon ELA, Chaves DM, Ishioka S, Souza TF, Matuguma SE, Sakai P. Echoguieded hepatico-gastrostomy: a case report. Clinics (Sao Paulo) 2007; 62:799-802 [PMID 18209925]

Ly J, O'Grady G, Mittal A, Plank L, Windsor JA. A systematic review of methods to palliate malignant gastric outlet obstruction. Surg Endosc 2010; 24(2):290-7 [PMID 19551436]

Jeurnink SM, Steyeberg EW, Van Hooft JE, Van Eijck CH, Schwartz MP, Vleggaar FP, et al. Surgical gastrojejunostomy or endoscopic stent placement for the palliation of malignant gastric outlet obstruction (SUSTENT study): a multicenter randomized trial. Gastrointest Endosc2010; 71(3):490-9 [PMID 20003966]

Adler GG, Baron TH. Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents:experience in 36 patients. Am J Gastroenterol 2002; 97(1):72-8. [PMID 11808972]

Kikuyama M, Itoi T, Sasada Y, Sofuni A, Ota Y, Itokawa F. Large-balloon technique for one-step endoscopic biliary stenting in patients with an inaccessible major papila owing to difficult duodenal stricture. Gastrointest Endosc 2009; 70(3):568-72. [PMID 19573866]

Iwamuro M, Kawamoto H, Harada R, Kato H, Hirao K, Mizuno O, et al. Combined duodenal stent placement and endoscopic ultrasonography-guided biliary drainage for malignant duodenal obstruction with biliary stricture. Dig Endosc2010; 22(3):236-40 [PMID 20642617]

Maire F, Hammel P, Ponst P, Aubert A, O'Toole D, Hentic O, et al. Long-term outcomes of biliary and duodenal stents in palliative treatment of patients with unresectable adenocarcinoma of the head of pancreas. Am J Gastroenterol2006; 101(4):735-42. [PMID 16635221]

Deployed biliary and duodenal stents
Published
2012-03-10
How to Cite
Maluf-Filho, F., Retes, F., Neves, C., Sato, C., Kawaguti, F., Jureidini, R., Ribeiro Jr, U., & Bacchella, T. (2012). Transduodenal Endosonography-Guided Biliary Drainage and Duodenal Stenting for Palliation of Malignant Obstructive Jaundice and Duodenal Obstruction. JOP. Journal of the Pancreas, 13(2), 210-214. https://doi.org/10.6092/1590-8577/653