EUS diagnosis and simultaneous endoscopic retrograde cholangiography treatment of common bile duct stones by using an oblique-viewing echoendoscope - 17/08/11
Reprint requests: Rodolfo Rocca, MD, Gastroenterology Department, A.S.O. Ordine Mauriziano, Largo Turati 62, 10138 Torino, Italy.Torino, Italy
Abstract |
Background |
MRCP and EUS have replaced ERCP in the diagnosis of biliary diseases, but the latter is needed for treatment. This study evaluates a new approach in the management of common bile duct stones, by using an oblique-viewing echoendoscope.
Methods |
Nineteen patients with acute abdominal pain associated with increased liver tests entered the study. Evaluation of the biliary tree was performed by using an oblique-viewing echoendoscope (JF-UM20; Olympus Europe GmbH, Hamburg, Germany). When biliary stones or sludge were found, bile duct cannulation and sphincterotomy were performed in the same session.
Results |
Bile duct stones were diagnosed by EUS in 4 patients and biliary sludge in 12; the subsequent cholangiography and sphincterotomy with stone extraction confirmed the diagnosis in all patients. Bile duct cannulation failed in 1 patient. EUS showed features of chronic pancreatitis in 3 cases. The mean time for the whole procedure (EUS plus endoscopic retrograde cholangiography with biliary treatment) was 27 minutes. No procedure-related complications were observed.
Conclusion |
This new approach appears to be feasible and safe, providing an accurate diagnosis and, at the same time, an appropriate treatment of common bile duct stones when needed. With technical improvements, this extended EUS technique could be used as the first-line procedure in patients with biliopancreatic diseases.
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| This work was presented, in part, as a poster at Digestive Diseases Week, May 16-22, 2003, Orlando, Florida (Gastrointest Endosc 2003;57:AB243[W1223]). |
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| This study was supported by a grant from Giuliani-Bracco, Italy. Dr Daperno has received a research grant from Fondazione per le Malattie Infiammatorie Croniche Intestinali, Torino, Italy, through a project funded by Fondazione Compagnia di San Paolo. All authors state that they have no conflict of interest to disclose. |
Vol 63 - N° 3
P. 479-484 - marzo 2006 Ritorno al numero
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