Endoscopic Ultrasound-Guided Biliary Drainage in Two Patients with Difficult Biliary Access
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.16/2288 |
Resumo: | Introduction: Endoscopic retrograde cholangiopancreatography is the method of choice for biliary drainage, although in some cases standard biliary access is difficult or even impossible. Endoscopic ultrasound (EUS)-guided endoluminal procedures are an alternative in these cases, although experience with these techniques is still limited. Clinical Case: We present two cases of successful EUS-guided biliary drainage. In the first case, a hepaticogastrostomy was performed in a patient with stage IV gastric adenocarcinoma with obstructive jaundice due to compression of the hilum, where malignant gastric stenosis and previous palliative gastrojejunostomy precluded access to the second part of the duodenum. In the second case, a patient with a pancreatic head adenocarcinoma with duodenal invasion that precluded major papillae identification was submitted to a choledochoduodenostomy. Both procedures occurred without immediate or delayed adverse events, with technical and clinical success. Discussion: Although experience with EUS-guided biliary drainage is still limited, its efficacy and safety is favorable when compared with percutaneous and surgical drainage, and should be considered an alternative to these techniques where sufficient expertise exists. |
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Endoscopic Ultrasound-Guided Biliary Drainage in Two Patients with Difficult Biliary AccessEndoscopic retrograde cholangiopancreatographyEndoscopic ultrasonographyBiliary drainagePalliative therapyGastrointestinal cancerColangiopancreatografia retrógrada endoscópicaDrenagem biliarecoendoscopiaterapêutica paliativaneoplasias gastrointestinaisIntroduction: Endoscopic retrograde cholangiopancreatography is the method of choice for biliary drainage, although in some cases standard biliary access is difficult or even impossible. Endoscopic ultrasound (EUS)-guided endoluminal procedures are an alternative in these cases, although experience with these techniques is still limited. Clinical Case: We present two cases of successful EUS-guided biliary drainage. In the first case, a hepaticogastrostomy was performed in a patient with stage IV gastric adenocarcinoma with obstructive jaundice due to compression of the hilum, where malignant gastric stenosis and previous palliative gastrojejunostomy precluded access to the second part of the duodenum. In the second case, a patient with a pancreatic head adenocarcinoma with duodenal invasion that precluded major papillae identification was submitted to a choledochoduodenostomy. Both procedures occurred without immediate or delayed adverse events, with technical and clinical success. Discussion: Although experience with EUS-guided biliary drainage is still limited, its efficacy and safety is favorable when compared with percutaneous and surgical drainage, and should be considered an alternative to these techniques where sufficient expertise exists.Introdução: A colangiopancreatografia retrógrada endoscópica é o procedimento de escolha para a drenagem biliar, embora em alguns casos o acesso biliar convencional é difícil ou até impossível. As técnicas de drenagem guiadas por ecoendoscopia são uma alternativa nestes casos, embora a experiência seja ainda limitada. Caso: Apresentamos dois casos de drenagem biliar eficaz guiada por ecoendoscopia. No primeiro caso foi realizada hepaticogastrostomia numa doente com adenocarcinoma gástrico estadio IV, com icterícia obstrutiva devido a compressão hilar pela neoplasia, na qual o acesso à segunda porção duodenal se revelou impossível devido à neoplasia gástrica estenosante e a antecedentes de gastrojejunostomia paliativa. No segundo caso, uma doente com adenocarcinoma cefalo-pancreático com invasão duodenal que impedia a identificação da papila foi submetida a coledocoduodenostomia. Em ambos os procedimentos foi conseguida drenagem biliar eficaz e não ocorreram eventos adversos imediatos ou tardios. Discussão: Apesar de a experiência com técnicas de drenagem biliar guiadas por ecoendoscopia ser limitada, o seu perfil de eficácia e segurança parece ser favorável quando comparada com as alternativas (drenagem percutânea ou cirúrgica), pelo que devem ser consideradas quando exista equipamento e experiência necessária.Karger Publishers Open AccessRepositório Científico do Centro Hospitalar Universitário de Santo AntónioLibânio, D.Giestas, S.Martinez-Ares, D.Ferreira, F.Canena, J.Certo, M.Lopes, L.2019-08-27T08:37:55Z2018-092018-09-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.16/2288engGE Port J Gastroenterol. 2018 Sep;25(5):258-2632341-454510.1159/000485429info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-10-20T10:59:58Zoai:repositorio.chporto.pt:10400.16/2288Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:38:30.369809Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Endoscopic Ultrasound-Guided Biliary Drainage in Two Patients with Difficult Biliary Access |
title |
Endoscopic Ultrasound-Guided Biliary Drainage in Two Patients with Difficult Biliary Access |
spellingShingle |
Endoscopic Ultrasound-Guided Biliary Drainage in Two Patients with Difficult Biliary Access Libânio, D. Endoscopic retrograde cholangiopancreatography Endoscopic ultrasonography Biliary drainage Palliative therapy Gastrointestinal cancer Colangiopancreatografia retrógrada endoscópica Drenagem biliar ecoendoscopia terapêutica paliativa neoplasias gastrointestinais |
title_short |
Endoscopic Ultrasound-Guided Biliary Drainage in Two Patients with Difficult Biliary Access |
title_full |
Endoscopic Ultrasound-Guided Biliary Drainage in Two Patients with Difficult Biliary Access |
title_fullStr |
Endoscopic Ultrasound-Guided Biliary Drainage in Two Patients with Difficult Biliary Access |
title_full_unstemmed |
Endoscopic Ultrasound-Guided Biliary Drainage in Two Patients with Difficult Biliary Access |
title_sort |
Endoscopic Ultrasound-Guided Biliary Drainage in Two Patients with Difficult Biliary Access |
author |
Libânio, D. |
author_facet |
Libânio, D. Giestas, S. Martinez-Ares, D. Ferreira, F. Canena, J. Certo, M. Lopes, L. |
author_role |
author |
author2 |
Giestas, S. Martinez-Ares, D. Ferreira, F. Canena, J. Certo, M. Lopes, L. |
author2_role |
author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório Científico do Centro Hospitalar Universitário de Santo António |
dc.contributor.author.fl_str_mv |
Libânio, D. Giestas, S. Martinez-Ares, D. Ferreira, F. Canena, J. Certo, M. Lopes, L. |
dc.subject.por.fl_str_mv |
Endoscopic retrograde cholangiopancreatography Endoscopic ultrasonography Biliary drainage Palliative therapy Gastrointestinal cancer Colangiopancreatografia retrógrada endoscópica Drenagem biliar ecoendoscopia terapêutica paliativa neoplasias gastrointestinais |
topic |
Endoscopic retrograde cholangiopancreatography Endoscopic ultrasonography Biliary drainage Palliative therapy Gastrointestinal cancer Colangiopancreatografia retrógrada endoscópica Drenagem biliar ecoendoscopia terapêutica paliativa neoplasias gastrointestinais |
description |
Introduction: Endoscopic retrograde cholangiopancreatography is the method of choice for biliary drainage, although in some cases standard biliary access is difficult or even impossible. Endoscopic ultrasound (EUS)-guided endoluminal procedures are an alternative in these cases, although experience with these techniques is still limited. Clinical Case: We present two cases of successful EUS-guided biliary drainage. In the first case, a hepaticogastrostomy was performed in a patient with stage IV gastric adenocarcinoma with obstructive jaundice due to compression of the hilum, where malignant gastric stenosis and previous palliative gastrojejunostomy precluded access to the second part of the duodenum. In the second case, a patient with a pancreatic head adenocarcinoma with duodenal invasion that precluded major papillae identification was submitted to a choledochoduodenostomy. Both procedures occurred without immediate or delayed adverse events, with technical and clinical success. Discussion: Although experience with EUS-guided biliary drainage is still limited, its efficacy and safety is favorable when compared with percutaneous and surgical drainage, and should be considered an alternative to these techniques where sufficient expertise exists. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-09 2018-09-01T00:00:00Z 2019-08-27T08:37:55Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.16/2288 |
url |
http://hdl.handle.net/10400.16/2288 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
GE Port J Gastroenterol. 2018 Sep;25(5):258-263 2341-4545 10.1159/000485429 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Karger Publishers Open Access |
publisher.none.fl_str_mv |
Karger Publishers Open Access |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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