Endoscopic ultrasound-guided bilioduodenal anastomosis: a new technique for biliary drainage

Endoscopy. 2001 Oct;33(10):898-900. doi: 10.1055/s-2001-17324.


Endoscopic biliary stenting is the most common method of treating obstructive jaundice. We present a new technique of biliary drainage using endoscopic ultrasound (EUS) and EUS-guided puncture of the common bile duct (CBD). A 56-year-old man with obstructive jaundice was referred for EUS and endoscopic retrograde cholangiopancreatography (ERCP) because a computed tomography (CT) scan had shown a pancreatic mass in the head of the pancreas and a dilated CBD. The patient was enrolled in a preoperative chemoradiotherapy protocol and biliary stenting was required. Deep cannulation was not obtained even after a precut and the procedure was stopped. Using a therapeutic EUS scope (FG 38X Pentax), the CBD was punctured with a 5-F needle-knife under EUS guidance and a cholangiogram was obtained. A 0.35-inch guide wire was introduced into the CBD. The EUS scope was removed and a duodenoscope was introduced, allowing the placement through the duodenum of a 10-F plastic stent. The CBD was drained properly. No complication occurred.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / complications*
  • Cholangiopancreatography, Endoscopic Retrograde / methods
  • Cholestasis / diagnostic imaging
  • Cholestasis / surgery*
  • Common Bile Duct
  • Drainage
  • Endosonography / methods*
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / complications*
  • Pancreaticoduodenectomy / methods
  • Punctures / methods
  • Stents*
  • Ultrasonography, Interventional / methods*