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Review
. 2015 Jan 21;21(3):820-8.
doi: 10.3748/wjg.v21.i3.820.

Technical tips of endoscopic ultrasound-guided choledochoduodenostomy

Takeshi Ogura  1 , Kazuhide Higuchi  1
Affiliations
Review

Technical tips of endoscopic ultrasound-guided choledochoduodenostomy

Takeshi Ogura et al. World J Gastroenterol. .

Abstract

Endoscopic ultrasound (EUS) is clinically useful not only as a diagnostic tool during EUS-guided fine needle aspiration, but also during interventional EUS. EUS-guided biliary drainage has been developed and performed by experienced endoscopists. EUS-guided choledocoduodenostomy (EUS-CDS) is relatively well established as an alternative biliary drainage method for biliary decompression in patients with biliary obstruction. The reported technical success rate of EUS-CDS ranges from 50% to 100%, and the clinical success rate ranges from 92% to 100%. Further, the over-all technical success rate was 93%, and clinical success rate was 98%. Based on the currently available literature, the overall adverse event rate for EUS-CDS is 16%. The data on the cumulative technical and clinical success rate for EUS-CDS is promising. However, EUS-CDS can still lead to several problems, so techniques or devices that are more feasible and safe need to be established. EUS-CDS has the potential to become a first-line biliary drainage procedure, although standardizing the technique in multicenter clinical trials and comparisons with endoscopic biliary drainage by randomized clinical trials are still needed.

Keywords: Endoscopic ultrasound; Endoscopic ultrasound-guided biliary drainage; Endoscopic ultrasound-guided choledochoduodenostomy; Percutaneous transhepatic biliary drainage.

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Figures

Figure 1
Figure 1
Endoscopic ultrasound-guided choledocoduodenostomy combined with duodenal stent. A: Endoscopic ultrasound-guided choledocoduodenostomy (EUS-CDS) was performed from duodenal bulb after duodenal stenting; B: Endoscopic view of EUS-CDS combined with duodenal stent.
Figure 2
Figure 2
Double puncture of duodenal mucosa. A: Double mucosa of duodenum on endoscopic ultrasound view (arrow); B: Endoscopic view of double puncture of duodenal mucosa.
Figure 3
Figure 3
Novel endoscopic ultrasound-guided fine needle aspiration needle (Sono Tip Pro Control 19 G needle, Medi-Globe GmbH, Rosenheim, Germany). The cut surface of this fine needle aspiration needle is 5 mm, and this needle has sharpness.
Figure 4
Figure 4
Cyst-wire (Medi-Globe GmbH, Rosenheim, Germany). To avoid wire sharing, top formation of this guidewire is coil.
Figure 5
Figure 5
Cysto-Gastro-Set (Endoflex, GmbH, Voerde, Germany). This devise is always coaxial with the guidewire.
Figure 6
Figure 6
Bile leak due to plastic stent of endoscopic ultrasound-guided choledocoduodenostomy. A: Endoscopic view of day 1; B: Day 2; C: Day 3; D: Computed tomography showed bile leak (arrow).
See this image and copyright information in PMC

References

    1. Fogel EL, Sherman S, Devereaux BM, Lehman GA. Therapeutic biliary endoscopy. Endoscopy. 2001;33:31–38. - PubMed
    1. Williams EJ, Taylor S, Fairclough P, Hamlyn A, Logan RF, Martin D, Riley SA, Veitch P, Wilkinson M, Williamson PJ, et al. Are we meeting the standards set for endoscopy? Results of a large-scale prospective survey of endoscopic retrograde cholangio-pancreatograph practice. Gut. 2007;56:821–829. - PMC - PubMed
    1. Oh HC, Lee SK, Lee TY, Kwon S, Lee SS, Seo DW, Kim MH. Analysis of percutaneous transhepatic cholangioscopy-related complications and the risk factors for those complications. Endoscopy. 2007;39:731–736. - PubMed
    1. Winick AB, Waybill PN, Venbrux AC. Complications of percutaneous transhepatic biliary interventions. Tech Vasc Interv Radiol. 2001;4:200–206. - PubMed
    1. Carrasco CH, Zornoza J, Bechtel WJ. Malignant biliary obstruction: complications of percutaneous biliary drainage. Radiology. 1984;152:343–346. - PubMed

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