Brief Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Endosc. May 16, 2013; 5(5): 246-250
Published online May 16, 2013. doi: 10.4253/wjge.v5.i5.246
Endocoil placement after endoscopic ultrasound-guided biliary drainage may prevent a bile leak
Schalk Willem van der Merwe, Jones Omoshoro-Jones, Charles Sanyika
Schalk Willem van der Merwe, Hepatology and GI Research Laboratory, Department of Immunology, University of Pretoria, Pretoria 0002, South Africa
Schalk Willem van der Merwe, Interventional Endoscopy Unit, Pretoria East Hospital, Pretoria 0044, South Africa
Jones Omoshoro-Jones, Department of Surgery, Chris Hani-Baragwanath Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2013, South Africa
Charles Sanyika, Department of Interventional radiology, WITS Donald Gordon Hospital, Johannesburg 2193, South Africa
Author contributions: van der Merwe SW, Omoshoro-Jones J and Sanyika C contributed to this paper.
Correspondence to: Schalk Willem van der Merwe, MBChB, PhD (Amsterdam), Professor, Interventional Endoscopy Unit, Pretoria East Hospital, Garsfontein Road, Pretoria 0044, South Africa. schalk.vandermerwe@uzleuven.be
Telephone: +32-16-344299 Fax: +32-16-344387
Received: June 28, 2012
Revised: February 12, 2013
Accepted: February 28, 2013
Published online: May 16, 2013
Abstract

AIM: To further reduce the risk of bleeding or bile leakage.

METHODS: We performed endoscopic ultrasound guided biliary drainage in 6 patients in whom endoscopic retrograde cholangiopancreatography (ERCP) had failed. Biliary access of a dilated segment 2 or 3 duct was achieved from the stomach using a 19G needle. After radiologically confirming access a guide wire was placed, a transhepatic tract created using a 6 Fr cystotome followed by balloon dilation of the stricture and antegrade metallic stent placement across the malignant obstruction. This was followed by placement of an endocoil in the transhepatic tract.

RESULTS: Dilated segmental ducts were observed in all patients with the linear endoscopic ultrasound scope from the proximal stomach. Transgastric biliary access was obtained using a 19G needle in all patients. Biliary drainage was achieved in all patients. Placement of an endocoil was possible in 5/6 patients. All patients responded to biliary drainage and no complications occurred.

CONCLUSION: We show that placing endocoils at the time of endoscopic ultrasound guided biliary stenting is feasible and may reduce the risk of bleeding or bile leakage.

Keywords: Endoscopic ultrasound, Biliary drainage, Transhepatic, Endocoil