Combined use of a two-channel endoscope and a flexible tip catheter for difficult biliary cannulation
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
A 69-year-old woman with jaundice was referred to our hospital. After a final diagnosis of pancreatic cancer with liver metastasis, we performed transpapillary biliary drainage with a covered self-expandable metal stent (SEMS). Three months later, we also placed an uncovered duodenal stent for duodenal stricture in a side-to-end fashion. Another month later, for biliary SEMS obstruction, we attempted a transpapillary approach. A duodenoscope was advanced and a guidewire was passed through the mesh of the duodenal stent into the bile duct with a flexible tip catheter, but the catheter was not. Thus, we exchanged the duodenoscope for a forward-viewing two-channel endoscope and used the left working channel with a flexible tip catheter. By adjusting the axis, we finally succeeded biliary cannulation and accomplished balloon cleaning for recanalization of the SEMS. This is the first case with successful biliary cannulation by combined use of a two-channel endoscope and a flexible tip catheter.
Abstract
A 69-year-old woman with jaundice was referred to our hospital. After a final diagnosis of pancreatic cancer with liver metastasis, we performed transpapillary biliary drainage with a covered self-expandable metal stent (SEMS). Three months later, we also placed an uncovered duodenal stent for duodenal stricture in a side-to-end fashion. Another month later, for biliary SEMS obstruction, we attempted a transpapillary approach. A duodenoscope was advanced and a guidewire was passed through the mesh of the duodenal stent into the bile duct with a flexible tip catheter, but the catheter was not. Thus, we exchanged the duodenoscope for a forward-viewing two-channel endoscope and used the left working channel with a flexible tip catheter. By adjusting the axis, we finally succeeded biliary cannulation and accomplished balloon cleaning for recanalization of the SEMS. This is the first case with successful biliary cannulation by combined use of a two-channel endoscope and a flexible tip catheter.
참고문헌 (6)
- Wang K, "Assessment of efficacy and safety of EUS-guided biliary drainage : a systematic review", Gastrointest Endosc, 83, pp.1218~1227 (2016)
- Nakahara K, "Therapeutic endoscopic retrograde cholangiopancreatography using an anterior oblique-viewing endoscope for bile duct stones in patients with prior Billroth II gastrectomy", J Gastroenterol, 44, pp.212~217 (2009)
- Nakahara K, "Endoscopic retrograde cholangiography using an anterior oblique-viewing endoscope in patients with altered gastrointestinal anatomy", Dig Dis Sci, 60, pp.944~950 (2015)
- Imazu H, "Initial evaluation of a novel multibending backward-oblique viewing duodenoscope in endoscopic retrograde cholangiopancreatography", Endoscopy, 44, pp.99~102 (2012)
- Igarashi Y, "A new cannula with a flexible tip(Swing Tip)may improve the success rate of endoscopic retrograde cholangiopancreatography", Endoscopy, 34, pp.628~631 (2002)
- Laasch HU, "Comparison of standard and steerable catheters for bile duct cannulation in ERCP", Endoscopy, 35, pp.669~674 (2003)