Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Dig Endosc. 2013 May;25 Suppl 2:137-41. doi: 10.1111/den.12084.
Various approaches to biliary drainage, especially endoscopic ultrasonography (EUS)-guided drainage, have become commonly used as an alternative method for biliary decompression for malignant biliary obstruction. Occasionally, however, duodenal obstruction and non-dilated intrahepatic bile duct impede conventional EUS-guided biliary drainage. Herein, we describe a case of cholecystogastrostomy successfully carried out using a newly developed fully covered lumen-apposing self-expandable metallic stent (SEMS). EUS-guided cholecystogastrostomy should be considered an option for biliary decompression. This is a particularly ideal alternative if the patient has duodenal strictures with or without a duodenal metal stent and a non-dilated intrahepatic bile duct, which suggests the impossibility of choledochoduodenostomy and hepaticogastrostomy. Furthermore, the newly developed fully covered lumen-apposing SEMS seems ideal for EUS-guided cholecystoenterostomy.
各种胆道引流方法，特别是内镜超声引导下引流，已成为恶性胆道梗阻胆道减压的一种常用替代方法。然而，偶尔会出现十二指肠梗阻和非扩张性肝内胆管阻碍常规的内镜超声引导下胆道引流。在此，我们描述了一例使用新开发的全覆膜腔贴合自膨式金属支架（SEMS）成功进行的胆囊-胃造口术。EUS 引导下胆囊-胃造口术应被视为胆道减压的一种选择。如果患者存在十二指肠狭窄伴或不伴十二指肠金属支架和非扩张性肝内胆管，则这是一种特别理想的替代方法，提示不可能进行胆肠吻合术和肝胃吻合术。此外，新开发的全覆膜腔贴合 SEMS 似乎非常适合 EUS 引导下的胆囊-肠吻合术。
