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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
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Endoscopic Ultrasound-Guided Biliary Drainage in Two Patients with Difficult Biliary Access
Diogo Libânio1,2, Sílvia Giestas2, David Martinez-Ares2
1Gastroenterology Department, Portuguese Oncology Institute of Porto, Porto, Portugal.
GE Portuguese Journal of Gastroenterology
|October 16, 2018
Summary
Endoscopic ultrasound (EUS)-guided biliary drainage offers a safe and effective alternative for patients with difficult biliary access. This minimally invasive approach shows promise compared to traditional methods.
Area of Science:
- Gastroenterology
- Interventional Endoscopy
- Oncology
Background:
- Endoscopic retrograde cholangiopancreatography (ERCP) is standard for biliary drainage but can be challenging.
- Endoscopic ultrasound (EUS)-guided procedures offer an alternative when standard ERCP access fails.
- Limited data exists on the efficacy and safety of EUS-guided biliary drainage.
Observation:
- Two cases of EUS-guided biliary drainage (hepaticogastrostomy and choledochoduodenostomy) were successfully performed.
- Case 1: Gastric adenocarcinoma with hilar compression and stenosis.
- Case 2: Pancreatic head adenocarcinoma with duodenal invasion precluding papillectomy.
Findings:
- Both EUS-guided procedures achieved technical and clinical success.
- No immediate or delayed adverse events were reported in either case.
- EUS-guided biliary drainage demonstrated favorable safety and efficacy.
Implications:
- EUS-guided biliary drainage is a viable alternative to percutaneous or surgical drainage for complex cases.
- This technique should be considered by centers with adequate expertise.
- Further research is warranted to expand the application of EUS-guided biliary interventions.
Keywords:
Biliary drainageEndoscopic retrograde cholangiopancreatographyEndoscopic ultrasonographyGastrointestinal cancerPalliative therapyMore Related Videos
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