Traversibility to the Papilla Decides the Feasibility of EUS-guided Cholangio-Pancreatic Access for Patients with Difficult Biliary Cannulation
نویسندگان
چکیده
EUS-guided direct cholangio-pancreatic access (EUS-DCP) may be feasible in patients with an inaccessible papilla [1], however, it poses a challenge due to its technical difficulty and relatively high complication rate [2,3]. EUS-rendezvous may be a more feasible alternative for antegrade cholangiopancreatography (EUS-RV) in patients with an inaccessible papilla than EUS-DCP. Even in expert hands, ERCP fails in 5-10% of cases [4], especially those with an inaccessible papilla associated with peri-ampullary or gallbladder cancer. Simultaneous double-stenting for the duodenum and bile duct has been attempted in patients with jaundice and duodenal obstruction [5]. While studies on EUS-guided pancreatobiliary drainage have been published [1,6-9], whether EUS-RV or EUS-DCP should be attempted first has not yet been elucidated. Therefore, we report based on our experience, the feasibility and superiority of EUSRV.
منابع مشابه
Papillary cannulation and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.
This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It provides practical advice on how to achieve successful cannulation and sphincterotomy at minimum risk to the patient. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main ...
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