Endoscopic ultrasound-guided choledoco-duodenostomy as an alternative to percutaneous trans-hepatic cholangiography.
BACKGROUND
Endoscopic ultrasonography (EUS)-guided choledochoduodenostomy (CDS) is an alternative to percutaneous transhepatic cholangiography (PTC) drainage in patients with an obstructed biliary system where conventional endoscopic retrograde biliary drainage (ERBD) has been unsuccessful.


METHODS
Five EUS-CDS procedures were reviewed to assess whether successful decompression was achieved and maintained.


RESULTS
There was technical success in each instance with no immediate complications. There was a significant fall in the median bilirubin of 164 mmol/l. The median follow-up was 44 days. In one patient the stent migrated with no adverse outcome.


CONCLUSIONS
EUS-CDS is a viable alternative to PTC with fewer complications and comparable success rates. EUS-CDS may offer a future route for novel therapeutic advances.
NIHR Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, UK. europac@liv.ac.uk
James A
JA
Nicholson
Marianne
M
Johnstone
Michael G T
MG
Raraty
Jonathan C
JC
Evans
D000368:Aged; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000295:instrumentation; D002768:Choledochostomy / Q000009:adverse effects / Q000295:instrumentation; D002779:Cholestasis / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004385:Duodenostomy / Q000009:adverse effects / Q000295:instrumentation; D019160:Endosonography; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D015415:Biomarkers; D001663:Bilirubin