Cholangioscopy-assisted guidewire placement in a malignant biliary stricture: A case report  

作　　者：Grace E Kim David Yung-An Lo 

机构地区：[1]Internal Medicine,University of Maryland Medical Center,Baltimore,MD 21201,United States [2]Department of Medicine,The Ohio State University College of Medicine,Ohio Gastroenterology Group,Inc,Columbus,OH 43214,United States

出　　处：《World Journal of Surgical Procedures》2020年第2期3-8,共6页世界外科手术杂志

摘　　要：BACKGROUND Cholangioscopy has been described in case reports and series to facilitate guidewire placement in difficult benign biliary strictures.Specifically,it has been infrequently used in difficult benign anastomotic liver transplant biliary strictures to visualize the stricture orifice for guidewire placement.Here we describe a case of guidewire placement through a difficult malignant biliary stricture using single operator cholangioscopy.CASE SUMMARY A 74-year-old female presented with jaundice and weight loss.Endoscopic ultrasound and endoscopic retrograde cholangiopancreatography(ERCP)by other endoscopists demonstrated pancreatic adenocarcinoma with a dilated cystic duct(CD)and proximal common bile duct(CBD).The associated distal CBD stricture was dilated and stented with a plastic stent.However she subsequently developed cholangitis,prompting referral for a repeat ERCP.The stent was found to have migrated distally to the confluence of the dilated CD and CBD stricture.Despite using multiple hydrophilic guidewires,the stricture could not be traversed due to preferential wire passage into the dilated CD.SpyGlass DS(Boston Scientific Corp,Marlborough,MA,United States)was then used to visualize the orifices of the CD and CBD stenosis,enabling the guidewire to be placed directly through the stricture into the proximal CBD.A WallFlex covered metal stent(Boston Scientific Corp,Marlborough,MA,United States)was successfully placed,resulting in resolution of her cholangitis.CONCLUSION To our knowledge,this is one of the first cases to describe successful cholangioscopic guidewire placement for malignant biliary strictures.

关 键 词：Cholangiopancreatoscopy Malignant biliary stricture CHOLANGIOSCOPY Guidewire placement Obstructive jaundice Case report 

分 类 号：R57[医药卫生—消化系统]