Mella José Manuel, Guidi Martín, De María Julio, Hwang Hui-Jer, Curvale Cecilia R, Matano Raúl
Sección Pancreatobiliar, Servicio de Gastroenterología, Hospital El Cruce, Florencio Varela, Buenos Aires, Argentina. E-mail:
Medicina (B Aires). 2015;75(5):311-4.
Endoscopic retrograde cholangiopancreatography (ERCP) is considered the first-approach for biliary drainage. In cases of ERCP failure, patients are usually referred for percutaneous transhepatic biliary drainage or surgical biliary bypass. In the last decade, the indications of endoscopic ultrasound (EUS) in the management of patients with pancreatic cancer have increased, and numerous cases of EUS-guided biliary drainage have been reported in patients with failures during the ERCP. Our goal is to report a patient with locally advanced pancreatic cancer who presented with painless jaundice and cholestasis with biliary and duodenal obstruction. A EUS-guided choledochoduodenostomy was performed by placement of a self-expanding metal stent.
内镜逆行胰胆管造影术(ERCP)被认为是胆管引流的首选方法。在ERCP失败的病例中,患者通常会被转诊进行经皮经肝胆道引流或外科胆道旁路手术。在过去十年中,内镜超声(EUS)在胰腺癌患者管理中的应用指征有所增加,并且有大量关于ERCP失败患者行EUS引导下胆道引流的病例报道。我们的目的是报告一名局部晚期胰腺癌患者,该患者出现无痛性黄疸和胆汁淤积伴胆管和十二指肠梗阻。通过放置自膨式金属支架进行了EUS引导下胆总管十二指肠吻合术。