Endoscopic ultrasound-guided gallbladder drainage to facilitate biliary rendezvous for the management of cholangitis due to choledocholithiasis.
نویسندگان
چکیده
An 81-year-old man presented with upper abdominal pain, nausea, and vomiting, with elevated liver test results. Abdominal computed tomography demonstrated mild intraand extrahepatic biliary ductal dilation (common bile duct 11mm), with choledocholithiasis, layering gallstones, and enhancement and thickening of the gallbladder wall. Endoscopic retrograde cholangiopancreatography (ERCP) was attempted, but biliary cannulation of an intradiverticular papilla failed, despite precut sphincterotomy. Endoscopic ultrasonography (EUS)-guided gallbladder drainage provided initial biliary decompression. Subsequently, biliary rendezvous via the gallbladder conduit facilitated conventional ERCP with sphincterotomy and stone extraction, as described below (▶Video1). After failed ERCP and during the same endoscopic session, an oblique-viewing, linear-array echoendoscope (Olympus, Tokyo, Japan) was passed in anticipation of biliary rendezvous. A decision was made to perform biliary decompression via the distended gallbladder, to address underlying cholecystitis in this poor operative candidate. Cholecystoduodenostomy (▶Fig. 1) was performed using a 19 G needle (Expect; Boston Scientific, Marlborough, Massachusetts, USA) for access, aspiration, and contrast injection. A 0.025 inch guidewire, 450 cm in length (VisiGlide; Olympus America, Center Valley, Pennsylvania, USA) was coiled E-Videos
منابع مشابه
The rendezvous technique involving insertion of a guidewire in a percutaneous transhepatic gallbladder drainage tube for biliary access in a case of difficult biliary cannulation
Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic method and treatment approach for biliary diseases. However, biliary cannulation can be difficult in some cases. We performed ERCP in a 97-year-old woman with abdominal pain resulting from acute cholangitis caused by choledocholithiasis and observed difficult biliary cannulation. Eventually, the patient was successfully treat...
متن کاملConversion of transpapillary drainage to endoscopic ultrasound-guided hepaticogastrostomy and gallbladder drainage in a case of malignant biliary obstruction with recurrent cholangitis and cholecystitis (with videos)
Endoscopic ultrasound-guided biliary drainage (EUS-BD) has been increasingly reported as an alternative to percutaneous transhepatic biliary drainage in failed endoscopic retrograde cholangiopancreatography. Moreover, conversion to EUS-BD can be a good alternative when transpapillary biliary drainage is technically possible but complicated by cholangitis because EUS-BD enables one-step internal...
متن کاملEndoscopic Ultrasound Guided Rendezvous Drainage of Biliary Obstruction Using a New Flexible 19-Gauge Fine Needle Aspiration Needle
Background and Aim. A successful endoscopic ultrasound guided rendezvous (EUS-RV) biliary drainage is dependent on accurate puncture of the bile duct and precise guide wire manipulation across the ampulla of Vater. We aim to study the feasibility of using a flexible 19-gauge fine aspiration needle in the performance of EUS-RV biliary drainage. Method. This is a retrospective case series of EUS-...
متن کاملP-THER-23: Maneuver of rendezvous and drainage of biliary track obstructed by papillary tumor
S33 ENDOSCOPIC ULTRASOUND / VOLUME 6 / SUPPLEMENT 1 / AUGUST 2017 Cosmas Rinaldi Lesmana Medistra Hospital, Jakarta, Indonesia Background and Objectives: Endoscopic retrograde cholangiopancreatography (ERCP) is still the most preferred method in Indonesia for patients with malignant obstructive jaundice. The role of therapeutic intervention endoscopic ultrasound (EUS) is still debatable regardi...
متن کاملTG13 flowchart for the management of acute cholangitis and cholecystitis.
We propose a management strategy for acute cholangitis and cholecystitis according to the severity assessment. For Grade I (mild) acute cholangitis, initial medical treatment including the use of antimicrobial agents may be sufficient for most cases. For non-responders to initial medical treatment, biliary drainage should be considered. For Grade II (moderate) acute cholangitis, early biliary d...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Endoscopy
دوره 49 12 شماره
صفحات -
تاریخ انتشار 2017