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Medline ® Abstract for Reference 44

of 'Therapeutic endoscopic ultrasound'

Endoscopic ultrasound-guided bilioduodenal anastomosis: a new technique for biliary drainage.
Giovannini M, Moutardier V, Pesenti C, Bories E, Lelong B, Delpero JR
Endoscopy. 2001;33(10):898.
Endoscopic biliary stenting is the most common method of treating obstructive jaundice. We present a new technique of biliary drainage using endoscopic ultrasound (EUS) and EUS-guided puncture of the common bile duct (CBD). A 56-year-old man with obstructive jaundice was referred for EUS and endoscopic retrograde cholangiopancreatography (ERCP) because a computed tomography (CT) scan had shown a pancreatic mass in the head of the pancreas and a dilated CBD. The patient was enrolled in a preoperative chemoradiotherapy protocol and biliary stenting was required. Deep cannulation was not obtained even after a precut and the procedure was stopped. Using a therapeutic EUS scope (FG 38X Pentax), the CBD was punctured with a 5-F needle-knife under EUS guidance and a cholangiogram was obtained. A 0.35-inch guide wire was introduced into the CBD. The EUS scope was removed and a duodenoscope was introduced, allowing the placement through the duodenum of a 10-F plastic stent. The CBD was drained properly. No complication occurred.
Endoscopy Unit, Paoli-Calmettes Institute, Marseilles, France. hdjchir@marseille.fnclcc.fr