Endoscopic Ultrasound-Guided Bilioduodenal Anastomosis: A New Technique for Biliary Drainage

• DOI: 10.1055/s-2001-17324
• Publication Date: 2002-07-26T11:37:40Z
• Authors: M. Giovannini; V. Moutardier; C. Pesenti; E. Bories; B. Lelong; J. Delpero
• Keywords: Cholangiopancreatography, Endoscopic Retrograde; Common Bile Duct; Male; Cholestasis; Punctures; Adenocarcinoma; Middle Aged; Endosonography; Pancreaticoduodenectomy; 3. Good health; Pancreatic Neoplasms; 03 medical and health sciences; 0302 clinical medicine; Drainage; Humans; Stents; Ultrasonography, Interventional

Endoscopic biliary stenting is the most common method of treating obstructive jaundice. We present a new technique of biliary drainage using endoscopic ultrasound (EUS) and EUS-guided puncture of the common bile duct (CBD). A 56-year-old man with obstructive jaundice was referred for EUS and endoscopic retrograde cholangiopancreatography (ERCP) because a computed tomography (CT) scan had shown a pancreatic mass in the head of the pancreas and a dilated CBD. The patient was enrolled in a preoperative chemoradiotherapy protocol and biliary stenting was required. Deep cannulation was not obtained even after a precut and the procedure was stopped. Using a therapeutic EUS scope (FG 38X Pentax), the CBD was punctured with a 5-F needle-knife under EUS guidance and a cholangiogram was obtained. A 0.35-inch guide wire was introduced into the CBD. The EUS scope was removed and a duodenoscope was introduced, allowing the placement through the duodenum of a 10-F plastic stent. The CBD was drained properly. No complication occurred.