ENDOSCOPIC ULTRASOUND-GUIDED DILATION OF COMPLETE CHOLEDOCHOJEJUNAL OBSTRUCTION USING A FORWARD-VIEWING ECHOENDOSCOPE

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  • 胆管空腸吻合部完全閉塞に対して直視コンベックス型EUSを用いた拡張術が有用であった１例

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Abstract

<p>A 69-year-old man who underwent subtotal stomach-conserving pancreatoduodenectomy developed complete obstruction of the anastomosis during the 10th postoperative month. He underwent cholangioscopy using single-balloon enteroscopy (SBE) and percutaneous transhepatic bile duct drainage; however, these procedures were unsuccessful. Therefore, we performed EUS-hepaticogastrostomy for internal fistulization. However, we detected intrahepatic stones, and considering the high risk of cholangitis, we performed release of the anastomotic stenosis from the jejunal aspect using a forward-viewing linear endoscopic ultrasound (FV-EUS). We subsequently performed anastomotic dilation and stone removal using SBE. Anastomotic dilation using FV-EUS in a patient with complete obstruction of a choledochojejunostomy facilitated subsequent stone removal and ongoing maintenance of the anastomosis.</p>

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