Transnasal removal of a biliary endoprosthesis with percutaneous transhepatic biliary catheter replacement.
The authors describe a novel fluoroscopically guided transnasal technique for removal of an endoscopically placed endobiliary prosthesis (EBP). A case in which the approach was applied is used to demonstrate its indications, clinical utility and possible benefits. The procedure entails simultaneous percutaneous replacement of the EBP with an internal/external biliary catheter over a through-and-through transhepatic/transnasal access wire. A comparison of the technique's limitations with those of traditional approaches for endoscopic or percutaneous EBP removal and replacement is presented.
Aultman
C J
CJ
Department of Radiology, Wilford Hall Medical Center, Lackland AFB, TX 78236-5300, USA.
Soares
G
G
Grayson
D E
DE
D000368:Aged; D017734:Bile Ducts, Extrahepatic; D002404:Catheterization / Q000379:methods; D020878:Device Removal / Q000379:methods*; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D015607:Stents