Endoscopic sphincterotomy assisted by percutaneous transhepatic choledochal tube: a preliminary report.
We report a method of endoscopic retrograde sphincterotomy in patients in whom the optimal viewing of the papilla of Vater is hardly obtained. Percutaneous transhepatic cholangiodrainage (PTCD)-tube is placed under ultrasonographic guidance. PTCD-tube coming out of the papilla of Vater is observed by the endoscope and the guide wire inside the shpincterotome is inserted into the PTCD-tube. Sphincterotome is advanced into the common bile duct by the guidance of the guide wire and PTCD-tube. Sphincterotomy is performed in a usual fashion. Two patients with previous history of gastrectomy underwent this procedure with successful results. This method should be tried when usual method of EST is difficult and unsuccessful.
Matsuoka
J
J
Okayama Central Hospital, Japan.
Kojima
K
K
Kurose
M
M
Takai
K
K
Gochi
A
A
Kamikawa
Y
Y
Tanaka
N
N
Orita
K
K
D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000000981:diagnostic imaging*; D001652:Bile Ducts / Q000000981:diagnostic imaging*; D002758:Cholangiography; D004322:Drainage / Q000379:methods; D042882:Gallstones / Q000601:surgery; D005743:Gastrectomy; D006801:Humans; D008297:Male; D016717:Sphincterotomy, Endoscopic / Q000379:methods*; D014463:Ultrasonography