The Korean Journal of Pancreas and Biliary Tract 2011;16(1):15-18.
췌장암에 의한 십이지장 협착 환자에서 내시경초음파 유도하 총담관-십이지장루 형성술 1예
문성훈, 김홍자
단국대학교 의과대학 내과학교실
Endoscopic Ultrasonography-guided Choledochoduodenostomy in Patient with Duodenal Stricture after a Failed Endoscopic Retrograde Cholangiopancreatography
Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
ABSTRACT
Endoscopic transpapillary biliary stenting is a well-established method for biliary decompression in patients with malignant biliary obstruction. When endoscopic transpapillary biliary access fails, percutaneous transhepatic biliary drainage is usually the next step. We here report a case of malignant biliary obstruction associated with pancreatic malignancy, in which endoscopic ultrasonography (EUS)-guided choledochoduodenostomy provided biliary decompression after a failed endoscopic retrograde cholangiopancreatography (ERCP). ERCP failed due to duodenal stricture associated with pancreatic malignancy. Compared with percutaneous transhepatic biliary drainage, EUS-guided biliary drainage has the merit of internal drainage and patient's comfort. EUS-guided choledochoduodenostomy, therefore, can be a rescue therapy after a failed ERCP.
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