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Endoscopic Ultrasound Guided Choledocho -Duodenostomy

Endoscopic Ultrasound Guided Choledocho -Duodenostomy

Background

A 55 year old lady presented with metastatic pancreatic head malignancy and obstructive jaundice. Duodenal infiltration was noted causing luminal narrowing (duodenoscope could not be negotiated).

Diagnosis And Treatment

EUS guided puncture of CBD was done from the first part of duodenum. After cholangiogram, the tract was dilated with cystotomes sequentially till 10 F and a 60x10mm fully covered biliary stent was deployed connecting D1 and CBD. A 7F 7cm double pigtail plastic biliary stent was deployed within the metal stent to prevent its displacement. There were no periprocedural complications. She had normalization of bilirubin in one week and she underwent chemotherapy.

Endoscopic Ultrasound Guided Choledocho -Duodenostomy

EUS guided puncture of CBD and cholangiogram

 

Endoscopic Ultrasound Guided Choledocho -Duodenostomy

Endoscopic Ultrasound Guided Choledocho -Duodenostomy

choledochoduodenostomywith a FCSSEMS(fully covered self expanding metal stent)

Endoscopic Ultrasound Guided Choledocho -Duodenostomy

Plastic stent with in theFCSEMS in D1

About Author –

Dr. A. Bharath Kumar, Consultant Interventional Gastroenterologist and Hepatologist, Yashoda Hospital, Hyderabad
MD, DM (Gastroenterology)

best Gastroenterologist in hyderabad

Dr. A. Bharath Kumar

MD, DM (Gastroenterology)
Consultant Interventional Gastroenterologist and Hepatologist

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