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. 1993 May;69(811):384–388. doi: 10.1136/pgmj.69.811.384

Combined transhepatic and endoscopic procedures in the biliary system.

A G Verstandig 1, E Goldin 1, T Sasson 1, G Weinberger 1, D Wengrower 1, A Fich 1, E Lax 1
PMCID: PMC2399820  PMID: 8346135

Abstract

Endoscopic biliary procedures are 89-97% successful in skilled hands. The commonest causes of failure are inability to cannulate the papilla of Vater due to difficult anatomy or tortuosity of the distal common bile duct and failure to cross a rigid biliary stricture. In nearly all of these cases, successful endoscopic procedures can be completed after percutaneous antegrade placement of a small catheter or guidewire to the duodenum. In 44 such combined procedures on 42 patients, the success rate was 43 (98%). There were two severe and eight mild complications. Combined procedures overcome the difficulties caused by tortuous biliary ducts and rigid strictures while obviating the need for more extensive percutaneous procedures and transhepatic tract dilatation.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ayela P., Ponchon T., Valette P. J., Chavaillon A., Maillet P. A combined endoscopic and radiological method for biliary drainage. Gastrointest Endosc. 1988 Jan-Feb;34(1):42–44. doi: 10.1016/s0016-5107(88)71228-6. [DOI] [PubMed] [Google Scholar]
  2. Brambs H. J., Billmann P., Pausch J., Holstege A., Salm R. Non-surgical biliary drainage: endoscopic conversion of percutaneous transhepatic into endoprosthetic drainage. Endoscopy. 1986 Mar;18(2):52–54. doi: 10.1055/s-2007-1018326. [DOI] [PubMed] [Google Scholar]
  3. Carrasco C. H., Zornoza J., Bechtel W. J. Malignant biliary obstruction: complications of percutaneous biliary drainage. Radiology. 1984 Aug;152(2):343–346. doi: 10.1148/radiology.152.2.6739796. [DOI] [PubMed] [Google Scholar]
  4. Chespak L. W., Ring E. J., Shapiro H. A., Gordon R. L., Ostroff J. W. Multidisciplinary approach to complex endoscopic biliary intervention. Radiology. 1989 Mar;170(3 Pt 2):995–997. doi: 10.1148/radiology.170.3.2916069. [DOI] [PubMed] [Google Scholar]
  5. Coons H. G. Self-expanding stainless steel biliary stents. Radiology. 1989 Mar;170(3 Pt 2):979–983. doi: 10.1148/radiology.170.3.2916066. [DOI] [PubMed] [Google Scholar]
  6. Foutch P. G., Chinichian A., Talbert G., Sanowski R. A. Endoscopic conversion of an external biliary drain to an internal common bile duct stent. Gastrointest Endosc. 1987 Oct;33(5):379–381. doi: 10.1016/s0016-5107(87)71645-9. [DOI] [PubMed] [Google Scholar]
  7. Hall R. I., Denyer M. E., Chapman A. H. Palliation of obstructive jaundice with a biliary endoprosthesis. Comparison of insertion by the percutaneous-transhepatic and the combined percutaneous-endoscopic routes. Clin Radiol. 1989 Mar;40(2):186–189. doi: 10.1016/s0009-9260(89)80089-3. [DOI] [PubMed] [Google Scholar]
  8. Irving J. D., Adam A., Dick R., Dondelinger R. F., Lunderquist A., Roche A. Gianturco expandable metallic biliary stents: results of a European clinical trial. Radiology. 1989 Aug;172(2):321–326. doi: 10.1148/radiology.172.2.2664861. [DOI] [PubMed] [Google Scholar]
  9. Kerlan R. K., Jr, Ring E. J., Pogany A. C., Jeffrey R. B., Jr Biliary endoprostheses. Insertion using a combined peroral-transhepatic method. Radiology. 1984 Mar;150(3):828–830. doi: 10.1148/radiology.150.3.6198675. [DOI] [PubMed] [Google Scholar]
  10. Long W. B., Schwarz W., Ring E. J. Endoscopic sphincterotomy assisted by catheterization antegrade. Gastrointest Endosc. 1984 Feb;30(1):36–39. doi: 10.1016/s0016-5107(84)72295-4. [DOI] [PubMed] [Google Scholar]
  11. Marks W. M., Freeny P. C., Ball T. J., Gannan R. M. Endoscopic retrograde biliary drainage. Radiology. 1984 Aug;152(2):357–360. doi: 10.1148/radiology.152.2.6739799. [DOI] [PubMed] [Google Scholar]
  12. Mason R. R., Cotton P. B. Combined endoscopic and percutaneous trans-cystic approach to a retained common duct stone. Br J Radiol. 1980 Jan;53(625):38–39. doi: 10.1259/0007-1285-53-625-38. [DOI] [PubMed] [Google Scholar]
  13. Mee A. S., Vallon A. G., Croker J. R., Cotton P. B. Non-operative removal of bile duct stones by duodenoscopic sphincterotomy in the elderly. Br Med J (Clin Res Ed) 1981 Aug 22;283(6290):521–523. doi: 10.1136/bmj.283.6290.521. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Mueller P. R., van Sonnenberg E., Ferrucci J. T., Jr Percutaneous biliary drainage: technical and catheter-related problems in 200 procedures. AJR Am J Roentgenol. 1982 Jan;138(1):17–23. doi: 10.2214/ajr.138.1.17. [DOI] [PubMed] [Google Scholar]
  15. Ring E. J., Oleaga J. A., Freiman D. B., Husted J. W., Lunderquist A. Therapeutic applications of catheter cholangiography. Radiology. 1978 Aug;128(2):333–338. doi: 10.1148/128.2.333. [DOI] [PubMed] [Google Scholar]
  16. Robertson D. A., Ayres R., Hacking C. N., Shepherd H., Birch S., Wright R. Experience with a combined percutaneous and endoscopic approach to stent insertion in malignant obstructive jaundice. Lancet. 1987 Dec 19;2(8573):1449–1452. doi: 10.1016/s0140-6736(87)91141-x. [DOI] [PubMed] [Google Scholar]
  17. Shorvon P. J., Cotton P. B., Mason R. R., Siegel J. H., Hatfield A. R. Percutaneous transhepatic assistance for duodenoscopic sphincterotomy. Gut. 1985 Dec;26(12):1373–1376. doi: 10.1136/gut.26.12.1373. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Speer A. G., Cotton P. B., Russell R. C., Mason R. R., Hatfield A. R., Leung J. W., MacRae K. D., Houghton J., Lennon C. A. Randomised trial of endoscopic versus percutaneous stent insertion in malignant obstructive jaundice. Lancet. 1987 Jul 11;2(8550):57–62. doi: 10.1016/s0140-6736(87)92733-4. [DOI] [PubMed] [Google Scholar]
  19. Tanaka M., Matsumoto S., Ikeda S., Miyazaki K., Yamauchi S. Endoscopic sphincterotomy in patients with difficult cannulation: use of an antegrade guide. Endoscopy. 1986 May;18(3):87–89. doi: 10.1055/s-2007-1013013. [DOI] [PubMed] [Google Scholar]
  20. Tsang T. K., Crampton A. R., Bernstein J. R., Buto S., Cahan J. A. Percutaneous-endoscopic biliary stenting in patients with occluded surgical bypass. Am J Med. 1990 Apr;88(4):344–348. doi: 10.1016/0002-9343(90)90487-x. [DOI] [PubMed] [Google Scholar]
  21. Yoshioka T., Sakaguchi H., Yoshimura H., Tamada T., Ohishi H., Uchida H., Wallace S. Expandable metallic biliary endoprostheses: preliminary clinical evaluation. Radiology. 1990 Oct;177(1):253–257. doi: 10.1148/radiology.177.1.2399327. [DOI] [PubMed] [Google Scholar]

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