title: Transduodenal endosonography-guided biliary drainage and duodenal stenting for palliation of malignant obstructive jaundice and duodenal obstruction.
abstract: BACKGROUND
  Endosonography-guided biliary drainage has been used over the last few years as a salvage procedure when endoscopic retrograde cholangiopancreatography fails. Malignant gastric outlet obstruction may also be present in these patients. We report the results of both procedures during the same session in patients with duodenal and biliary obstruction due to malignant disease.
  
  
  METHODS
  A retrospective review from a prospective collected database.
  
  
  RESULTS
  Technical success was achieved in all five patients; however, only three patients experienced relief of jaundice and gastric outlet obstruction.
  
  
  CONCLUSIONS
  Endosonography-guided biliary drainage and duodenal stenting in the same session is feasible. However, severe complications may limit the procedure. This is a challenging procedure and should be done by experts with special attention to patient's selection.
authors.affiliation: Cancer Institute of São Paulo University Medical School, São Paulo, SP, Brazil. fauze.maulf@terra.com.br
authors.forename: Fauze
authors.initials: F
authors.lastname: Maluf-Filho
authors.forename: Felipe Alves
authors.initials: FA
authors.lastname: Retes
authors.forename: Carla Zanellato
authors.initials: CZ
authors.lastname: Neves
authors.forename: Cezar Fabiano Manabu
authors.initials: CF
authors.lastname: Sato
authors.forename: Fabio Shiguehissa
authors.initials: FS
authors.lastname: Kawaguti
authors.forename: Ricardo
authors.initials: R
authors.lastname: Jureidini
authors.forename: Ulysses
authors.initials: U
authors.lastname: Ribeiro
authors.forename: Telesforo
authors.initials: T
authors.lastname: Bacchella
mesh_terms: D000230:Adenocarcinoma / Q000150:complications; D000368:Aged; D000369:Aged, 80 and over; D001659:Biliary Tract / Q000000981:diagnostic imaging; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D004322:Drainage / Q000379:methods; D004386:Duodenum / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D041781:Jaundice, Obstructive / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018307:Neoplasms, Squamous Cell / Q000150:complications; D010166:Palliative Care / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000150:complications; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000150:complications