title: Extrahepatic anterograde covered self-expandable metallic stent placement across malignant biliary obstruction passed by endoscopic ultrasound guidance access: a challenging technique.
abstract: The authors report the case of a female patient submitted to endoscopic cholangiography intending to drain the biliary tree due to jaundice. The patient had gastrointestinal deviation due to an advanced gastric cancer that evolved with a distal extrahepatic mass. Abdominal CT scan demonstrated a distal mass, extrahepatic biliary dilation and a normal intra-hepatic tree. In this condition and after a multidisciplinary discussion, an endoscopic ultrasound guided extrahepatic access with the deployment of a partially covered self-expandable metallic stent was performed. The patient normalized her bilirubin levels after a successful procedure.
authors.affiliation: Surgery, Gastroenterology and Radiology Departments, University of São Paulo, Brazil. eartifon@hotmail.com
authors.forename: Everson L A
authors.initials: EL
authors.lastname: Artifon
authors.forename: Flavio
authors.initials: F
authors.lastname: Ferreira
authors.forename: Gustavo
authors.initials: G
authors.lastname: Benevides
authors.forename: Federico H
authors.initials: FH
authors.lastname: Marcaccio
authors.forename: Jose Pinhata
authors.initials: JP
authors.lastname: Otoch
authors.forename: Jonas
authors.initials: J
authors.lastname: Takada
authors.forename: Francisco C
authors.initials: FC
authors.lastname: Carnevale
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Mota
authors.forename: Eduardo
authors.initials: E
authors.lastname: Moura
authors.forename: Samir
authors.initials: S
authors.lastname: Rasslan
authors.forename: Luiz Poli
authors.initials: LP
authors.lastname: de Figueiredo
authors.forename: Paulo
authors.initials: P
authors.lastname: Sakai
mesh_terms: D000208:Acute Disease; D000368:Aged; D001650:Bile Duct Neoplasms / Q000150:complications / Q000628:therapy*; D004322:Drainage / Q000295:instrumentation; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology / Q000628:therapy*; D008488:Medical Illustration; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods