Malign biliyer darlıkta endoskopik ultrasonografi eşliğinde biliyer drenaj: Olgu sunumu

Year 2020, , 69 - 72, 30.08.2020

Nuretdin Suna Diğdem Etik Nomingerel Tseveldorj Fatih Hilmioğlu

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

Abstract

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.

Keywords

Malign biliyer darlık, biliyer drenaj, endoskopik ultrasonografi

Endoscopic Ultrasound-Guided Biliary Drainage for Malignant Biliary Obstruction

Abstract

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.

Keywords

Malignant biliary obstruction, endoscopic ultrasonography, biliary drainage

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