Ultrasonography-guided endoscopic stent placement for malignant biliary obstruction: a preliminary report of four cases.
We present a new combination of transabdominal ultrasound (US) and biliary endoscopy, with endoscopic stent placement carried out under US guidance. Four patients (two men, two women; average age 66.2 years) underwent US-guided stent placement for palliation of ampullary carcinoma (n = 3) or pancreatic cancer (n = 1). A guide wire and a guiding catheter were endoscopically introduced and identified, by US in the common bile duct across the stricture. Hydromer-coated polyurethane angled stents (10 Fr) were finally inserted over the guide wire/guiding catheter by a pusher tube system. Successful drainage, with substantial reduction in bilirubin level, was achieved in all patients (14.2 +/- 9.5 vs. 4.2 +/- 2.9 mg/dl at 1 week). The present case series shows that endoscopic stent placement performed under US guidance is safe and effective. Further studies of larger series, including more proximal strictures, are warranted.
De Palma
G D
GD
Department of Surgery and Advanced Technologies, Section of Diagnostic and Therapeutic Endoscopy, University Federico II, School of Medicine, Naples, Italy. gdepalma@arrotino.it
Puzziello
A
A
Rega
M
M
Mastantuono
L
L
Persico
F
F
Patrone
F
F
Persico
G
G
D000368:Aged; D001661:Biliary Tract Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D002779:Cholestasis / Q000601:surgery*; D003135:Common Bile Duct / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012449:Safety; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional