scholarly journals Duodenal Metal Stent Placement after Endoscopic Ultrasonography-Guided Choledochoduodenostomy for Bile Duct Obstruction with Duodenal Stenosis: A Case Report

2020 ◽  
Vol 69 (2) ◽  
pp. 171-176
Author(s):  
Koji TAKAHASHI
Keyword(s):  
Case Report ◽  
Bile Duct ◽  
Endoscopic Ultrasonography ◽  
Stent Placement ◽  
Bile Duct Obstruction ◽  
Duodenal Stenosis ◽  
Metal Stent ◽  
Duct Obstruction

scholarly journals Feasibility and Safety of Endoluminal Radiofrequency Ablation as a Rescue Treatment for Bilateral Metal Stent Obstruction Due to Tumor Ingrowth in the Hilum: A Pilot Study

2021 ◽  
Vol 10 (5) ◽  
pp. 952
Author(s):  
Hoonsub So ◽  
Chi Hyuk Oh ◽  
Tae Jun Song ◽  
Hyun Woo Lee ◽  
Jun Seong Hwang ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Bile Duct ◽  
Adverse Events ◽  
Bile Duct Obstruction ◽  
Metal Stents ◽  
Metal Stent ◽  
Duct Obstruction ◽  
Tumor Ingrowth ◽  
Malignant Bile Duct Obstruction ◽  
Hilar Bile Duct

Background. Radiofrequency ablation (RFA) is a palliative method known for its application in the endoscopic treatment of malignant bile duct obstruction. It may be a useful rescue method for metal stent malfunction caused by tumor ingrowth. This study aimed to examine the feasibility and safety of endoluminal RFA for occluded bilateral hilar metal stents due to tumor ingrowth in patients with malignant hilar bile duct obstruction. Methods: From March 2016 to June 2018, 11 patients with unresectable malignant hilar bile duct stricture with occluded bilateral hilar metal stents due to tumor ingrowth were enrolled. Endoluminal RFA was performed through a novel temperature-controlled catheter at a setting of 7 W power for 120 s with a target temperature of 80 °C via endoscopic retrograde cholangiopancreatography (ERCP). The patients’ demographics, clinical outcomes, and adverse events were investigated. Results: The median age was 64 (interquartile range, 54–72) years. All RFA procedures were successful. Clinical success was achieved in eight patients (72.7%). During the follow-up, eight patients (72.7%) showed stent dysfunction, and the median patency after RFA was 50 days (95% confidence interval (CI): 34–not available (NA)). All stent dysfunctions were successfully managed with ERCP. Ten patients died, and the median overall survival was 289 days (95% CI, 107–NA) from RFA to death. There was one case of mild abdominal pain after the procedure without serious adverse events. Conclusions: As a rescue therapy for occluded bilateral hilar metal stents due to tumor ingrowth, endoluminal RFA seemed to be safe and useful in selected patients.

Biliary cirrhosis secondary to bile duct obstruction by hamartomatous polyps in a patient with Peutz–Jeghers syndrome. Case Report

2017 ◽  
Vol 40 (7) ◽  
pp. 459-462
Author(s):  
Miguel Angel Vichido-Luna ◽  
Flora Zárate-Mondragón ◽  
María Antonieta Mora-Tiscareño ◽  
Roberto Cervantes-Bustamante ◽  
Jaime Alfonso Ramírez-Mayans
Keyword(s):  
Case Report ◽  
Bile Duct ◽  
Bile Duct Obstruction ◽  
Biliary Cirrhosis ◽  
Hamartomatous Polyps ◽  
Duct Obstruction ◽  
Peutz Jeghers Syndrome

Endoscopic ultrasound-guided gallbladder drainage as a rescue therapy for unresectable malignant biliary obstruction: a multicenter experience

Endoscopy ◽  
2020 ◽  
Author(s):  
Danny Issa ◽  
Shayan Irani ◽  
Ryan Law ◽  
Shawn Shah ◽  
Sean Bhalla ◽  
...  
Keyword(s):  
Bile Duct ◽  
Success Rate ◽  
Clinical Success ◽  
Rescue Therapy ◽  
Bile Duct Obstruction ◽  
Distal Bile Duct ◽  
Metal Stent ◽  
Ultrasound Guided ◽  
Duct Obstruction ◽  
Gallbladder Drainage

Abstract Background Endoscopic retrograde cholangiopancreatography (ERCP) is often unsuccessful in patients with duodenal stenosis or malignant ampullary infiltration. While endoscopic ultrasound-guided biliary drainage (EUS-BD) has been proposed as an alternative, EUS-guided gallbladder drainage (EUS-GBD) is an attractive option when both approaches fail. We aimed to assess the effectiveness and safety of EUS-GBD as rescue therapy for malignant distal bile duct obstruction. Methods A multicenter retrospective study was performed on patients with unresectable malignant distal bile duct obstruction who underwent EUS-GBD between 2014 and 2019 after unsuccessful ERCP and EUS-BD. Clinical success was defined as a decrease in serum bilirubin of > 50 % within 2 weeks. Results 28 patients were included, with a lumen-apposing metal stent used in 26 (93 %) and a self-expandable metal stent in two (7 %). The technical success rate was 100 %. The clinical success rate was 93 %, with an improvement in bilirubin (7.3 [SD 5.4] pre-procedure vs. 2.8 [SD 1.1] post-procedure; P = 0.001). Delayed adverse events included food impaction of the stent (n = 3), with a further two patients developing cholecystitis and bleeding. Conclusion This study demonstrates the feasibility of gallbladder drainage to relieve malignant distal bile duct obstruction in patients with failed ERCP and EUS-BD.

Sign in / Sign up

Export Citation Format

Share Document