Abstract
We herein report three cases with unresectable malignant biliary stenosis in which transgastohepatic endosonography-guided biliary drainage (ESBD) was performed. In ESBD, a dilated intrahepatic duct was punctured via the stomach under endosonographic guidance, followed by placement of a guidewire through the puncture needle, and dilation of the puncture route and stent deployment over the guidewire.
Case 1. A 76-year-old woman with bile duct carcinoma underwent endoscopic biliary drainage (EBD). When the stent occluded, the intrahepatic bile duct was divided. Case 2. A 62-year-old man with recurrence of gallbladder cancer underwent EBD, but stent occlusion occurred frequently. Case 3. A 84-year-old woman with recurrent intrahepatic bile duct carcinoma. It was not possible to reach the papilla of Vater due to previous hepaticojejunostomy.
Transgastohepatic ESBD is a useful technique for biliary drainage in difficult EBD cases and may replace percutaneous transhepatic biliary drainage in many situations of obstructive jaundice.
