Año 2025 / Volumen 117 / Número 10
Carta
Endoscopic ultrasound-guided gallbladder drainage as a second option of biliary decompression after failed endoscopic retrograde cholangiopancreatography for the management of malignant distal biliary obstruction

593-594

DOI: 10.17235/reed.2023.9973/2023

Carlos Miguel Chavarría Herbozo, Lorena Sancho-del Val, Cristina Cuadrado-Tiemblo, Cristina Vicente Martín, Luis Wong Becerra, Daniel Riado Mínguez,

Resumen
Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is recommended as a rescue treatment of malignant distal biliary obstruction (MBDO) after failed ERCP and endoscopic ultrasound-guided biliary drainage (EUS-BD). A 64-year-old male was admitted for painless obstructive jaundice and anemia. For religious reasons, he refused any blood transfusions. Abdominal computed tomography scan showed a pancreatic tumor with dilation biliary tree and liver metastasis. ERCP failed and advanced biliary cannulation technique such as precut were avoided due to a high risk of bleeding. We avoided the two transmural EUS-BD approaches, which include EUS-guided choledochoduodenostomy and EUS-guided hepaticogastrostomy, due to smaller targets and considered riskier in this patient. Since the gallbladder was markedly distended and the cystic duct was patent, we performed a cholecystogastrostomy with a 15x10 mm electrocautery lumen-apposing metal stent (EC-LAMS) as a second option of biliary drainage. After a week, the serum bilirubin levels decreased to normal values and the patient was uneventfully discharged. At follow-up, he refused to receive chemotherapy and died six months later due to cancer progression.
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Bibliografía
1. Imai H, Kitano M, Omoto S, et al. EUS-guided gallbladder drainage for rescue treatment of malignant distal biliary obstruction after unsuccessful ERCP. Gastrointest Endosc. 2016;84(1):147-51.
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Instrucciones para citar
Chavarría Herbozo C, Sancho-del Val L, Cuadrado-Tiemblo C, Vicente Martín C, Wong Becerra L, Riado Mínguez D, et all. Endoscopic ultrasound-guided gallbladder drainage as a second option of biliary decompression after failed endoscopic retrograde cholangiopancreatography for the management of malignant distal biliary obstruction. 9973/2023


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Ficha Técnica

Recibido: 20/09/2023

Aceptado: 23/09/2023

Prepublicado: 26/10/2023

Publicado: 10/10/2025

Tiempo de prepublicación: 36 días

Tiempo de edición del artículo: 751 días


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