Matsuoka J, Kojima K, Kurose M, Takai K, Gochi A, Kamikawa Y, Tanaka N, Orita K
Okayama Central Hospital, Japan.
Acta Med Okayama. 1997 Feb;51(1):51-4. doi: 10.18926/AMO/30805.
We report a method of endoscopic retrograde sphincterotomy in patients in whom the optimal viewing of the papilla of Vater is hardly obtained. Percutaneous transhepatic cholangiodrainage (PTCD)-tube is placed under ultrasonographic guidance. PTCD-tube coming out of the papilla of Vater is observed by the endoscope and the guide wire inside the shpincterotome is inserted into the PTCD-tube. Sphincterotome is advanced into the common bile duct by the guidance of the guide wire and PTCD-tube. Sphincterotomy is performed in a usual fashion. Two patients with previous history of gastrectomy underwent this procedure with successful results. This method should be tried when usual method of EST is difficult and unsuccessful.
