Endoscopic ultrasound-guided choledochoduodenostomy and duodenal stenting in patients with unresectable periampullary cancer: one-step procedure by using linear echoendoscope

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Arquivos
art_ARTIFON_Endoscopic_ultrasound_guided_choledochoduodenostomy_and_duodenal_stenting_in_2013.PDF (256 KB)
Citações na Scopus
11
Tipo de produção
article
Data de publicação
2013
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
INFORMA HEALTHCARE
Autores
FRAZAO, Mariana S. V.
WODAK, Stephanie
RABELLO, Carolina
Citação
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, v.48, n.3, p.374-379, 2013
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objective. Describe a case series of endoscopic ultrasound (EUS)-guided choledochoduodenostomy (BUS-CD) associated with duodenal self-expandable metal stents (SEMS) placement using solely the linear echoendoscope in seven patients with obstructive jaundice and duodenal obstruction due to unresectable periampullary cancer. Material and methods. EUS-CD in the first portion of the duodenum, associated with duodenal SEMS placement was performed in seven patients with unresectable periampullary cancer with obstructive jaundice and invasive duodenal obstruction. Laboratory tests and clinical follow-up were performed until patient's death. The procedure was performed by an experienced endoscopist under conscious sedation. The puncture position was chosen based on EUS evaluation, at the common bile duct (CBD) above the tumor, through the distal part of the duodenal bulb. After that, the needle was withdrawn and a wire-guided needle knife was used to enlarge the site puncture in the duodenal wall. Then, a partially covered SEMS was passed over the guide, through the choledochoduodenal fistula. Duodenal SEMS placement was performed during the same endoscopic procedure. Results. The procedure was performed in seven patients, ranging between 34 and 86 years. Technical success of EUS-CD, by the stent placement, occurred in 100% of the cases. There were no early complications. Duodenal SEMS placement was effective in 100% of the cases that remained alive after a follow-up of 7 and 30 days. Conclusion. The results suggest therapeutic BUS one-step procedure drainage as an alternative for these patients, with good clinical success, feasible technique and safety.
Palavras-chave
cholangiography, choledochostomy, common bile duct, digestive system neoplasms, drainage/methods, interventional, jaundice obstructive, neoplasms, stents, ultrasonography
URI
https://observatorio.fm.usp.br/handle/OPI/1950
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Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - FM/MCG
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/26
Artigos e Materiais de Revistas Científicas - LIM/35
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