Korean J Pancreas Biliary Tract.  2020 Jul;25(2):128-134. 10.15279/kpba.2020.25.2.128.

Three Cases of Difficult Bile Duct Stone Removal by EUS-guided Choledochoduodenostomy

• Jeong YJ
• Choi MK
• Hong SG

• KMID: 2505004
• DOI: http://doi.org/10.15279/kpba.2020.25.2.128

Abstract

After failed removal of common bile duct or intrahepatic bile duct (IHD) stones by endoscopic retrograde cholangiopancreatography (ERCP), percutaneous lithotripsy is well-known as an effective procedure. However, it is time-consuming because multiple sessions of transhepatic tract dilatation are required. Endoscopic ultrasound (EUS)-guided choledochoduodenostomy (CDS) has been recently used to approach IHD to remove difficult bile duct stones. We recently experienced EUS-guided CDS performed with metal stent. Common bile duct or IHD stones were removed by retrieval accessories after initial failed or inadequate ERCP in three patients. Serious complications including bleeding, infection, and perforation were not noted. The duration of hospital stay from EUS-guided procedure to discharge ranged from 10 to 14 days. Although this result is interim and ongoing, it suggests that EUS-guided CDS might be an effective and safe procedure after failed ERCP to remove difficult bile duct stones through the tract.

Keyword

담관결석; 내시경 초음파; 담관십이지장문합술; Bile duct stone; Endoscopic ultrasound; Choledochoduodenostomy