Refractory benign biliary stricture due to chronic pancreatitis in two patients treated using endoscopic ultrasound-guided choledochoduodenostomy fistula creation: case reports

Benign biliary stricture (BBS) is a complication of chronic pancreatitis (CP). Despite endoscopic biliary stenting, some patients do not respond to treatment, and they experience recurrent cholangitis. We report two cases of CP with refractory BBS treated using endoscopic ultrasound-guided choledoch...

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Bibliographic Details
Published in:Clinical endoscopy 2024, 57(1), , pp.122-127
Main Authors: Ishikawa, Sho, Okuno, Nozomi, Hara, Kazuo, Mizuno, Nobumasa, Haba, Shin, Kuwahara, Takamichi, Kuraishi, Yasuhiro, Yanaidani, Takafumi
Format: Article
Language:English
Subjects:
benign biliary stricture
biliary drainage
chronic pancreatitis
endoscopic ultrasound-guided choledochoduodenostomy
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Summary:Benign biliary stricture (BBS) is a complication of chronic pancreatitis (CP). Despite endoscopic biliary stenting, some patients do not respond to treatment, and they experience recurrent cholangitis. We report two cases of CP with refractory BBS treated using endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) fistula creation. A 50-year-old woman and a 60-year-old man both presented with obstructive jaundice secondary to BBS due to alcoholic CP. They underwent repeated placement of a fully covered self-expandable metal stent for biliary strictures. However, the strictures persisted, causing repeated episodes of cholangitis. Therefore, an EUS-CDS was performed. The stents were eventually removed and the patients became stent-free. These fistulas have remained patent without cholangitis for more than 2.5 years. Fistula creation using EUS-CDS is an effective treatment option for BBS.
ISSN:2234-2400
2234-2443
DOI:10.5946/ce.2022.149