Endoscopic ultrasound-guided choledochoantrostomy as an alternative extrahepatic bile duct drainage method in pancreatic cancer with duodenal invasion

2013 ◽  
Vol 25 ◽  
pp. 142-145 ◽  
Author(s):  
Takao Itoi ◽  
Fumihide Itokawa ◽  
Takayoshi Tsuchiya ◽  
Shujiro Tsuji ◽  
Ryosuke Tonozuka
Keyword(s):  
Pancreatic Cancer ◽  
Bile Duct ◽  
Endoscopic Ultrasound ◽  
Extrahepatic Bile Duct ◽  
Ultrasound Guided ◽  
Duodenal Invasion

scholarly journals Endoscopic ultrasonography-guided cholecystogastrostomy in a patient with pancreatic cancer: the first case in Colombia (with video)

2020 ◽  
Vol 35 (4) ◽  
pp. 527-532
Author(s):  
Renzo Pinto-Carta ◽  
Jaime Solano Mariño ◽  
Luis Felipe Cabrera Vargas ◽  
Erika Johana Benito Flórez
Keyword(s):  
Pancreatic Cancer ◽  
Bile Duct ◽  
Third World ◽  
Extrahepatic Bile Duct ◽  
Bile Leakage ◽  
Current Treatment ◽  
Curative Intent ◽  
Palliative Intent ◽  
First Case ◽  
Duodenal Invasion

The current treatment of malignant biliary obstruction is non-surgical biliary diversion with palliative intent, the surgery having specific indications in patients with malignant pathology with curative intent. However, duodenal obstruction and non-dilated intra- or extrahepatic bile duct make these surgical and endoscopic procedures guided by EUS difficult. We present our experience with the first case in Colombia a third-world country in Latin America of a cholecystogastrostomy guided by EUS in a patient with unresectable pancreatic cancer and duodenal invasion with dilated common bile duct using a luminal stent (LAMS) (HOT stent AXIOS; Xlumena Inc., Mountain View, CA, USA) 15mm x 10mm.EUS-guided cholecystogastrostomy should be considered as an option for biliary decompression of greater importance than percutaneous drainage since it is superior in terms of technical feasibility, safety and efficacy in specific cases of ampullary stenosis and duodenal invasion. In addition, it can be done in third world countries when it has the appropriate training and implements. The fully covered metal stent applied to light (HOT AXIOS stent, Xlumena Inc., Mountain View, CA, USA) is ideal for EUS guided cholecystogastrostomy to minimize complications such as bile leakage. Additional comparative studies are needed to validate the benefits of this technique.

scholarly journals A Proposed Algorithm for Endoscopic Ultrasound-Guided Rendezvous Technique in Failed Biliary Cannulation

2020 ◽  
Vol 9 (12) ◽  
pp. 3879
Author(s):  
Saburo Matsubara ◽  
Keito Nakagawa ◽  
Kentaro Suda ◽  
Takeshi Otsuka ◽  
Hiroyuki Isayama ◽  
...  
Keyword(s):  
Bile Duct ◽  
Endoscopic Ultrasound ◽  
Extrahepatic Bile Duct ◽  
Intrahepatic Bile Duct ◽  
Duodenal Bulb ◽  
Ultrasound Guided ◽  
Biliary Cannulation ◽  
Rendezvous Technique ◽  
Selection Of ◽  
Approach Route

Background: The selection of an approach route in endoscopic ultrasound-guided rendezvous (EUS-RV) for failed biliary cannulation is complicated. We proposed an algorithm for EUS-RV. Methods: We retrospectively evaluated consecutive EUS-RV cases between April 2017 and July 2020. Puncturing the distal extrahepatic bile duct (EHBD) from the duodenal second part (D2) (DEHBD/D2 route) was attempted first. If necessary, puncturing the proximal EHBD from the duodenal bulb (D1) (PEHBD/D1 route), puncturing the left intrahepatic bile duct (IHBD) from the stomach (LIHBD/S route), or puncturing the right IHBD from the D1 (RIHBD/D1 route) were attempted in this order. Results: A total of 16 patients were included. The DEHBD/D2 route was used in 10 (62.5%) patients. The PEHBD/D1 route was attempted in five (31.3%) patients, and the biliary puncture failed in one patient in whom the RIHBD/D1 route was used because of tumor invasion to the left hepatic lobe. The LIHBD/S route was applied in one (6.3%) patient. Successful biliary cannulation was achieved in all patients eventually. The time from the puncture to the guidewire placement in the DEHBD/D2 route (3.5 min) was shorter than that in other methods (14.0 min) (p = 0.014). Adverse events occurred in one (6.3%) patient with moderate pancreatitis. Conclusions: The proposed algorithm might be useful for the selection of an appropriate approach route in EUS-RV.

scholarly journals Endoscopic ultrasound-guided rendezvous for extrahepatic bile duct recanalization after surgical transection

Endoscopy ◽  
2021 ◽  
Author(s):  
Diego Martínez-Acitores de la Mata ◽  
Lucía Zabalza ◽  
Verónica Ubieto ◽  
José Luis Moya ◽  
Juan Carrascosa ◽  
...  
Keyword(s):  
Bile Duct ◽  
Endoscopic Ultrasound ◽  
Extrahepatic Bile Duct ◽  
Ultrasound Guided

scholarly journals Infected Pancreatic Necrosis Mimicking Pancreatic Cancer

2020 ◽  
Vol 14 (2) ◽  
pp. 436-442
Author(s):  
Jun Heo
Keyword(s):  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Pancreatic Necrosis ◽  
Necrotizing Pancreatitis ◽  
Needle Aspiration ◽  
Infected Pancreatic Necrosis ◽  
Ultrasound Guided ◽  
Fine Needle

Although infected pancreatic necrosis can develop as a result of rare conditions involving trauma, surgery, and systemic infection with an uncommon pathogen, it usually occurs as a complication of pancreatitis. Early phase of acute pancreatitis can be either edematous interstitial pancreatitis or necrotizing pancreatitis. The late complications of pancreatitis can be divided into pancreatic pseudocyst due to edematous interstitial pancreatitis or walled-off necrosis due to necrotizing pancreatitis. During any time course of pancreatitis, bacteremia can provoke infection inside or outside the pancreas. The patients with infected pancreatic necrosis may have fever, chills, and abdominal pain as inflammatory symptoms. These specific clinical presentations can differentiate infected pancreatic necrosis from other pancreatic diseases. Herein, I report an atypical case of infected pancreatic necrosis in which abdominal pain, elevation of white blood cell, and fever were not found at the time of admission. Rather, a 10-kg weight loss (from 81 to 71 kg) over 2 months nearly led to a misdiagnosis of pancreatic cancer. The patient was finally diagnosed based on endoscopic ultrasound-guided fine-needle aspiration. This case highlights that awareness of the natural course of pancreatitis and infected pancreatic necrosis is important. In addition, endoscopic ultrasound-guided fine-needle aspiration should be recommended for the diagnosis and treatment of indeterminate pancreatic lesions in selected patients.

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