Endoscopic ultrasound-guided gallbladder drainage in pancreatic cancer and cholangitis: A case report
作者机构：Department of GastroenterologyGarbagnate Milanese HospitalASST RhodenseMilan 20024Italy Department of GastroenterologyCardarelli HospitalNaples 80131Italy Department of GastroenterologyFederico II UniversityNaples 80100Italy Digestive Endoscopy UnitFondazione Policlinico Universitario A.GemelliIRCCSRoma 00168Italy
出 版 物：《World Journal of Gastrointestinal Endoscopy》 (世界胃肠内镜杂志（英文版）（电子版）)
年 卷 期：2020年第12卷第11期
页 面：488-492页
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100214[医学-肿瘤学] 10[医学]
主 题：Gallbladder drainage Endoscopy ultrasound Pancreatic cancer Cholangitis Case report Axios stent
摘 要：BACKGROUND Head pancreatic cancers often present with clinical challenges requiring biliary drainage for chemotherapy or palliative *** usual endoscopic modalities fail or if percutaneous approach is not feasible,endoscopic ultrasound(EUS)guided biliary drainage can be *** we describe and discuss an interesting clinical case in which EUS-guided gallbladder drainage(EUS-GBD)was chosen to treat acute severe cholangitis in a patient with advanced pancreatic *** SUMMARY An 84-year-old female with a previous EUS-biopsy proven diagnosis of head pancreatic cancer presented with clinical signs of acute *** September 2018 she had positioned a biliary and duodenal stent to relieve jaundice and an initial duodenal *** the emergency ward,an abdominal computed tomography scan showed proximal biliary stent occlusion due to neoplastic progression,but endoscopic retrograde cholangiopancreatography was impossible because of worsening duodenal stenosis and the absence of a chance to reach the Vater’s papilla ***-guided choledocoduodenostomy was not technically feasible but because the cystic duct was free of neoplastic infiltration,an EUS-GBD using an Axios^TM stent was successfully *** patient started to feed after 48 h and was discharged 1 wk *** other hospitalizations due to cholangitis or symptoms of Axios^TM stent occlusion/dysfunction were observed up until her death 6 mo later due to underlying *** This case demonstrated how different EUS therapeutic approaches could have a key role to treat critical and seemingly unsolvable situations and that they could play a more fundamental role in the next future.
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