title: Endoscopic ultrasound-guided biliary drainage for right hepatic bile duct obstruction: novel technical tips.
abstract: Endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) is not normally indicated for an obstructed right intrahepatic bile duct (IHBD). The technical feasibility and clinical efficacy of a novel technique of EUS-BD for right IHBD obstruction were evaluated. A total of 11 patients underwent drainage using either a left or a right biliary access route. The causes of obstructive jaundice were cholangiocarcinoma (n = 6), pancreatic cancer (n = 3), gastric cancer (n = 1), and colon cancer (n = 1). After placement of an uncovered metal stent to bridge the obstruction, a hepaticogastrostomy was completed using a covered stent. Mean procedure time was 33.9 ± 10.0 minutes. Technical and functional success were achieved in all patients, and no adverse events occurred. This novel method appears to be safe and effective for right IHBD obstruction.
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ogura
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Tatsushi
authors.initials: T
authors.lastname: Sano
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Saori
authors.initials: S
authors.lastname: Onda
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Imoto
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Masuda
authors.affiliation: Department of Radiology, Osaka Medical College, Osaka, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kitano
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Takeuchi
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Inoue
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Higuchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001651:Cholestasis, Extrahepatic / Q000000981:diagnostic imaging / Q000628:therapy*; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D019160:Endosonography; D005240:Feasibility Studies; D005260:Female; D006500:Hepatic Duct, Common; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015607:Stents; D018084:Ultrasonography, Interventional