Malign biliyer darlıkta endoskopik ultrasonografi eşliğinde biliyer drenaj: Olgu sunumu

Yıl 2020, , 69 - 72, 30.08.2020

Nuretdin Suna Diğdem Etik Nomingerel Tseveldorj Fatih Hilmioğlu

https://doi.org/10.17940/endoskopi.795824

Öz

Endoskopik retrograd kolanjiyopankreatografi, pankreatikobiliyer drenajda ilk tercih edilen yöntemdir. Ancak lüminal obstrüksiyonu ya da cerrahi ile anatomisi değiştirilmiş olan hastalarda endoskopik retrograd kolanjiyopankreatografi işlemi zor ve hatta bazen imkansız olabilir. Endoskopik retrograd kolanjiyopankreatografi işlemi mümkün olmayan hastalarda en yaygın kullanılan yöntem olan perkütan transhepatik biliyer drenaj, yüksek advers olaylar ile ilişkilidir. Bu nedenle, biliyer drenajı sağlamak için daha az invaziv olan alternatif yöntemlere ihtiyaç duyulmaktadır. Son iki dekatta, perkütan transhepatik biliyer yöntemine alternatif olarak bazı deneyimli merkezlerde uygulanan endoskopik ultrasonografi eşliğinde biliyer drenaj daha az advers olaylar ile ilişkilidir. Bu yazıda, pankreas başı kanserinin duodenum duvarına ve papillaya invazyonu nedeniyle endoskopik retrograd kolanjiyopankreatografi yapılamayan bir olguda endoskopik ultrasonografi eşliğinde gerçekleştirilen biliyer drenaj uygulanmasını sunuyoruz.

Anahtar Kelimeler

Malign biliyer darlık, biliyer drenaj, endoskopik ultrasonografi

Endoscopic Ultrasound-Guided Biliary Drainage for Malignant Biliary Obstruction

Öz

Endoscopic retrograde cholangiopancreatography is the most preferable choice for pancreatobiliary drainage. Unfortunately, the endoscopic retrograde cholangiopancreatography procedure is difficult and even impossible for patients with duodenal luminal obstruction or surgically altered anatomy. If endoscopic retrograde cholangiopancreatography could not be performed, in such case, percutaneous transhepatic biliary drainage is the most commonly used method despite having many serious adverse events. Because of the adverse events, other less invasive methods for biliary drainage are needed. In the past two decades, in some expert centers, endoscopic ultrasound-guided biliary drainage, which has less adverse events, has replaced percutaneous transhepatic biliary drainage as the alternative drainage method. In this case report, we presented a patient with a pancreatic head tumor that had invaded the duodenal wall and papilla who underwent endoscopic ultrasound-guided biliary drainage after a failed endoscopic retrograde cholangiopancreatography.

Anahtar Kelimeler

Malignant biliary obstruction, endoscopic ultrasonography, biliary drainage

Kaynakça

• 1- Carr-Locke DL. Overview of the role of ERCP in the management of diseases of the biliary tract and the pancreas. Gastrointest Endosc 2002; 56(6 Suppl):S157-60.
• 2- Coté GA, Singh S, Bucksot LG, et al. Association between volume of endoscopic retrograde cholangiopancreatography at an academic medical center and use of pancreatobiliary therapy. Clin Gastroenterol Hepatol 2012;10:920-4.
• 3- Yarmohammadi H, Covey AM. Percutaneous biliary interventions and complications in malignant bileduct obstruction. Chin Clin Oncol 2016;5:68.
• 4- Nennstiel S, Weber A, Frick G, et al. Drainage-related Complications in Percutaneous Transhepatic Biliary Drainage: An Analysis Over 10 Years. J Clin Gastroenterol 2015;49:764-70.
• 5- Giovannini M, Moutardier V, Pesenti C, et al. Endoscopic ultrasound-guided bilioduodenal anastomosis: a new technique for biliary drainage. Endoscopy 2001;33:898-900.
• 6- Khan MA, Akbar A, Baron TH, et al. Endoscopic ultrasound-guided biliary drainage: A systematic review and meta-analysis. Dig Dis Sci 2016;61:684-703.
• 7- Salerno R, Davies SEC, Mezzina N, Ardizzone S. Comprehensive review on EUS-guided biliary drainage.World J Gastrointest Endosc 2019;11:354-64.
• 8- Imai H, Kitano M, Omoto S, et al. EUS-guided gallbladder drainage for rescue treatment of malignant distal biliary obstruction after unsuccessful ERCP. Gastrointest Endosc 2016;84:147-51.
• 9- Itoi T, Binmoeller K, Itokawa F, Umeda J, Tanaka R. Endoscopic ultrasonography-guided cholecystogastrostomy using a lumen-apposing metal stent as an alternative to extrahepatic bile duct drainage in pancreatic cancer with duodenal invasion. Dig Endosc 2013;25(Suppl 2):137-41.
• 10- Artifon EL, Marson FP, Gaidhane M, Kahaleh M, Otoch JP. Hepaticogastrostomy or choledochoduodenostomy for distal malignant biliary obstruction after failed ERCP: is there any difference? Gastrointest Endosc 2015;81:950-9.
• 11- Khashab MA, Messallam AA, Penas I, et al. International multicenter comparative trial of transluminal EUS-guided biliary drainage via hepatogastrostomy vs. choledochoduodenostomy approaches. Endosc Int Open 2016;4:E175-81.