Urgent endoscopic ultrasound-guided choledochoduodenostomy for acute obstructive suppurative cholangitis-induced sepsis.
Acute obstructive suppurative cholangitis (AOSC) due to biliary lithiasis is a life-threatening condition that requires urgent biliary decompression. Although endoscopic retrograde cholangiopancreatography (ERCP) with stent placement is the current gold standard for biliary decompression, it can sometimes be difficult because of failed biliary cannulation. In this retrospective case series, we describe three cases of successful biliary drainage with recovery from septic shock after urgent endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) was performed for AOSC due to biliary lithiasis. In all three cases, technical success in inserting the stents was achieved and the patients completely recovered from AOSC with sepsis in a few days after EUS-CDS. There were no procedure-related complications. When initial ERCP fails, EUS-CDS can be an effective life-saving endoscopic biliary decompression procedure that shortens the procedure time and prevents post-ERCP pancreatitis, particularly in patients with AOSC-induced sepsis.
Kosuke Minaga, Masayuki Kitano, Hajime Imai, Kentaro Yamao, Ken Kamata, Takeshi Miyata, Shunsuke Omoto, Kumpei Kadosaka, Tomoe Yoshikawa, Masatoshi Kudo, Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama 589-8511, Japan.
Kosuke
K
Minaga
Kosuke Minaga, Masayuki Kitano, Hajime Imai, Kentaro Yamao, Ken Kamata, Takeshi Miyata, Shunsuke Omoto, Kumpei Kadosaka, Tomoe Yoshikawa, Masatoshi Kudo, Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama 589-8511, Japan.
Masayuki
M
Kitano
Kosuke Minaga, Masayuki Kitano, Hajime Imai, Kentaro Yamao, Ken Kamata, Takeshi Miyata, Shunsuke Omoto, Kumpei Kadosaka, Tomoe Yoshikawa, Masatoshi Kudo, Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama 589-8511, Japan.
Hajime
H
Imai
Kosuke Minaga, Masayuki Kitano, Hajime Imai, Kentaro Yamao, Ken Kamata, Takeshi Miyata, Shunsuke Omoto, Kumpei Kadosaka, Tomoe Yoshikawa, Masatoshi Kudo, Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama 589-8511, Japan.
Kentaro
K
Yamao
Kosuke Minaga, Masayuki Kitano, Hajime Imai, Kentaro Yamao, Ken Kamata, Takeshi Miyata, Shunsuke Omoto, Kumpei Kadosaka, Tomoe Yoshikawa, Masatoshi Kudo, Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama 589-8511, Japan.
Ken
K
Kamata
Kosuke Minaga, Masayuki Kitano, Hajime Imai, Kentaro Yamao, Ken Kamata, Takeshi Miyata, Shunsuke Omoto, Kumpei Kadosaka, Tomoe Yoshikawa, Masatoshi Kudo, Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama 589-8511, Japan.
Takeshi
T
Miyata
Kosuke Minaga, Masayuki Kitano, Hajime Imai, Kentaro Yamao, Ken Kamata, Takeshi Miyata, Shunsuke Omoto, Kumpei Kadosaka, Tomoe Yoshikawa, Masatoshi Kudo, Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama 589-8511, Japan.
Shunsuke
S
Omoto
Kosuke Minaga, Masayuki Kitano, Hajime Imai, Kentaro Yamao, Ken Kamata, Takeshi Miyata, Shunsuke Omoto, Kumpei Kadosaka, Tomoe Yoshikawa, Masatoshi Kudo, Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama 589-8511, Japan.
Kumpei
K
Kadosaka
Kosuke Minaga, Masayuki Kitano, Hajime Imai, Kentaro Yamao, Ken Kamata, Takeshi Miyata, Shunsuke Omoto, Kumpei Kadosaka, Tomoe Yoshikawa, Masatoshi Kudo, Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama 589-8511, Japan.
Tomoe
T
Yoshikawa
Kosuke Minaga, Masayuki Kitano, Hajime Imai, Kentaro Yamao, Ken Kamata, Takeshi Miyata, Shunsuke Omoto, Kumpei Kadosaka, Tomoe Yoshikawa, Masatoshi Kudo, Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama 589-8511, Japan.
Masatoshi
M
Kudo
D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D002768:Choledochostomy / Q000295:instrumentation / Q000379:methods*; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D018805:Sepsis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D015607:Stents; D013492:Suppuration; D016896:Treatment Outcome
Acute obstructive suppurative cholangitis; Choledochoduodenostomy; Endoscopic ultrasound-guided biliary drainage; Life-saving endoscopy; Sepsis