Endoscopic Ultrasound Guided Therapy of Benign and Malignant Biliary Obstruction: A Case Series

Püspök, Andreas; Lomoschitz, Friedrich; Dejaco, Clemens; Hejna, Michael; Sautner, Thomas; Gangl, Alfred
August 2005
American Journal of Gastroenterology;Aug2005, Vol. 100 Issue 8, p1743
Academic Journal
OBJECTIVES: Endoscopic retrograde cholangiography is an established method for treatment of common bile duct stones as well as for palliation of patients with malignant pancreaticobiliary strictures. It may be unsuccessful in the presence of a complex peripapillary diverticulum, prior surgery, obstructing tumor, papillary stenosis, or impacted stones. Percutaneous transhepatic biliary drainage and surgery are alternative methods with a higher morbidity and mortality in these cases. Recently, endoscopic ultrasound (EUS) guided biliary stent placement has been described in patients with malignant biliary obstruction. We describe our experience with this method that was also used for the treatment of cholangiolithiasis for the first time. METHODS: The EUS guided transduodenal puncture of the common bile duct with stent placement was performed in 5 patients. In 2 of these patients, the stents were removed after several weeks and common bile duct stones were extracted. In another patient with gastrectomy, the left intrahepatic bile duct was punctured transjejunally and a metal stent was introduced transhepatically to bridge a distal common bile duct stenosis. RESULTS: Biliary decompression was successful in all 6 patients. No immediate complications occurred. One patient developed a subacute phlegmonous cholecystitis. CONCLUSIONS: Interventional EUS guided biliary drainage is a new technique that allows drainage of the biliary system in benign and malignant diseases when the bile duct is inaccessible by conventional ERCP. (Am J Gastroenterol 2005;100:1–5)


Related Articles

  • Biliary atresia: the Croatian experience 1992-2006. Grizelj, Ruža; Vuković, Jurica; Novak, Milivoj; Batinica, Stipe; Grizelj, Ruža; Vuković, Jurica // European Journal of Pediatrics;Dec2010, Vol. 169 Issue 12, p1529 

    The objective of this study was to determine the outcomes of Croatian children with biliary atresia. Health records of infants born in Croatia between January 1, 1992 and December 31, 2006 who were diagnosed with biliary atresia and treated at a single university center were reviewed. Survival...

  • Participation of natural killer cells in the pathogenesis of bile duct lesions in biliary atresia. Okamura, Atsushi; Harada, Kenichi; Nio, Masaki; Nakanuma, Yasuni // Journal of Clinical Pathology;Feb2013, Vol. 66 Issue 2, p99 

    Aims Immunological disturbances including innate immunity after a suspected viral infection are considered important to the pathogenesis of bile duct lesions in cases of biliary atresia (BA). In this study, we tried to evaluate whether natural killer (NK) cells and CX3CL1 (Fractalkine) and its...

  • Biliary atresia and cerebellar hypoplasia in polysplenia syndrome. Vanderdood, Kurt; Op de Beeck, Bart; Desprechins, Brigitte; Osteaux, Michel // Pediatric Radiology;Sep2003, Vol. 33 Issue 9, p652 

    We report a 3.5-month-old boy with polysplenia syndrome who demonstrated hemiazygos continuation of the inferior vena cava, extrahepatic biliary atresia, multiple splenunculi, bowel malrotation, and the rare finding of brainstem and cerebellar hypoplasia. A possible pathogenesis for cerebellar...

  • Late Kasai? Mack, David; Thompson, Jon S. // American Journal of Gastroenterology;Sep2001, Vol. 96 Issue 9, p2537 

    Discusses whether Kasai operation should be recommended to children older than 3 months diagnosed with biliary atresia. Details of liver transplantation; Comparison of patients who undergo and did not undergo Kasai operations; Survival rate of patients who undergo Kasai operation.

  • ATRESIA OF THE GALLBLADDER. Bair, Robert C.; Miller, Joseph M. // American Journal of Gastroenterology;Jul1961, Vol. 36 Issue 1, p78 

    Provides information on the atresia of the gallbladder condition. Comparison of the symptoms of agenesis and atresia of the gall bladder; Details of a patient with atresia of the gallbladder; Treatment for a patient with an agenesis of the gallbladder.

  • Emily's angel. Chalmers, Gill // Australian Women's Weekly;Mar2004, Vol. 74 Issue 3, p151 

    Recounts the fight of five-year-old Emily Hellowell, daughter of Michelle and Doug Hellowell, against biliary atresia. Medical history of Emily; Description of biliary atresia; Survival rate after a liver transplant.

  • CITATIONS AND CLINICIANS' NOTES: HEPATIC DISORDERS.  // Current Medical Literature: Pediatrics;2004, Vol. 17 Issue 2, p52 

    Discusses research being done on biliary atresia in infants. Reference to a study by M. Davenport, V. Puricelli, P. Farrant et al., published in a 2004 issue of "Journal of Pediatric Surgery"; Success rate of kasai portoenterostomy treatment in Great Britain; Alternative procedure for the...

  • Biliary atresia. Hartley, Jane; Harnden, Anthony; Kelly, Deirdre // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;5/29/2010, Vol. 340 Issue 7757, p1192 

    The article offers information on biliary atresia, a serious liver disorder that manifests with jaundice in the first few weeks of life in healthy infants. It describes the case of a mother who presented to her general practitioner her three week old son with mild jaundice. Among the reasons for...

  • Computerized three-dimensional study of a rotavirus model of biliary atresia: comparison with human biliary atresia. Chan, Regina Y. Y.; Tan, Carolyn E. L.; Czech-Schmidt, Gerard; Petersen, Claus // Pediatric Surgery International;Aug2005, Vol. 21 Issue 8, p615 

    Biliary atresia is a panbiliary disease causing obstructive jaundice in neonates and infants. The clinical spectrum can be broadly categorized into the fetal and perinatal types. A consistent animal model that accurately mimics the whole clinical spectrum of biliary atresia is not yet available....


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics