Endoscopic ultrasound-guided choledochoduodenostomy in patients with failed endoscopic retrograde ch

来源 :世界胃肠病学杂志(英文版) | 被引量 : 0次 | 上传用户:yaoyanfeiyu
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
Endoscopic ultrasonography (EUS)-guided biliary drainage was performed for treatment of patients who have obstructive jaundice in cases of failed endoscopic retrograde cholangiopancreatography (ERCP). In the present study, we introduced the feasibility and outcome of EUS-guided choledochoduodenostomy in four patients who failed in ERCP. We performed the procedure in 2 papilla of Vater, including one resectable case, and 2 cases of cancer of the head of pancreas. Using a curved linear array echoendoscope, a 19 G needle or a needle knife was punctured transduodenally into the bile duct under EUS visualization. Using a biliary catheter for dilation, or papillary balloon dilator, a 7-Fr plastic stent was inserted through the choledochoduodenostomy site into the extrahepatic bile duct. In 3 (75%) of 4 cases, an indwelling plastic stent was placed, and in one case in which the stent could not be advanced into the bile duct, a naso-biliary drainage tube was placed instead. In all cases, the obstructive jaundice rapidly improved after the procedure. Focal peritonitis and bleeding not requiring blood transfusion was seen in one case. In this case, pancreatoduodenectomy was performed and the surgical findings revealed severe adhesion around the choledochoduodenostomy site. Although further studies and development of devices are mandatory, EUS-guided choledochoduodenostomy appears to be an effective alternative to ERCP in selected cases.
其他文献
Combined duplication of the colon and vermiform appendix is one of the rare congenital anomalities of the alimentary tract. Only a few cases have been reported
Despite the continual evolution in the surgical treatment of adolescent idiopathic scoliosis (AIS), the goals of surgery remain to correct and stabilize the def
The molecular targets of sunitinib are receptor tyrosine kinases (RTKs), and this drug has also been known to exert blocking effects on the activation of KIT, w
AIM: To investigate the prevalence and genotype dis-tribution of Torque tend virus (TFV) in patients with different liver diseases and chronic renal failure tre
AIM: To investigate whether the major kavalactone kavain imposes adverse effects on the liver ultrastructure and function by affecting vascular and microvascula
The definition of large stones is not clear ranging from 10 mm to 15 mm and does not include the lower common bile duct (CBD) diameter. Three hundred and four p
Background Nucleostemin is essential for the proliferation and survival of stem and cancer cells,but it is unknown whether this newly identified molecule is inv
Aortic dissection and aortic aneurysm are two of the most common catastrophic events involving the aorta. Thoracic endovascular aortic repair is now considered
对流换热系数是计算围岩壁面与风流之间热交换量的重要参数。根据矿井风流与围岩热湿交换理论,提出测算井下巷道平均对流换热系数的方法。并在现场进行实测,通过对实测结果的
Objective:To identify clinicopathological factors predictive of lymph node metastases(LNM)in early signet ring cell carcinoma(SRC),and further to expand the pos