Endoscopic ultrasound-guided biliary drainage performed for refractory bile duct stenosis due to chronic...

We report a case of the patient who underwent endoscopic ultrasound-guided biliary drainage (EUS-BD) for refractory bile duct stenosis due to chronic pancreatitis. The patient had repeatedly undergone endoscopic biliary stenting for bile duct stenosis due to chronic pancreatitis. Because of repeated relapses of cholangitis and jaundice, transpapillary treatment was judged to have reached its limits. Surgical bypass was attempted but had to be abandoned due to adhesions. Thus, EUS-BD was performed. The procedure was successful, and placement of a covered expandable metallic stent (C-EMS) relieved cholangitis. Two months after placement, the C-EMS was removed, and the patient became stent-free but closure of the fistula subsequently occurred.