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ORIGINAL ARTICLE
Year : 2012  |  Volume : 1  |  Issue : 3  |  Page : 156-161

A one-step procedure by using linear echoendoscope to perform EUS-guided choledochoduodenostomy and duodenal stenting in patients with irresectable periampullary cancer


Department of Surgery, University of Sao Paulo (USP), Brazil

Correspondence Address:
Everson L.A. Artifon
Department of Surgery, University of Sao Paulo (USP)
Brazil
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Source of Support: None, Conflict of Interest: None


DOI: 10.7178/eus.03.007

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Objective: Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CD) has become an alternative method after unsuc­cessful endoscopic retrograde cholangiopancreatography (ERCP) treatment. We present a case series study and its feasibility by using only a linear therapeutic channel echoendoscope to create both a biliary-enteral fistula and anatomic enteral recanalization. Methods: We presented seven cases of unresectable periampullary cancer with both biliary and duodenal obstruction. In these cases, the EUS-guided technique might be an alternative to double stenting (biliary and enteral) in the same procedure and equip­ment. Results: In all cases, the location of the biliary obstruction was in the distal common bile duct (CBD) and the grade of proximal dilation diameter varied from 15 mm to 20 mm. Two patients had type I (28.6%) and five had type II (71.4%) duodenal obstruction. Technical success of EUS-CD, by the stent placement, occurred in 100% of the cases. There were no early complications. Biliary drainage was effective clinically as well as in laboratory in 6 cases (6/7), by relieving obstructive jaundice and decreasing bilirubin levels. Conclusion: EUS equipment may offer an alternative to double stenting in the same procedure and with palliative propose.


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