Severe bleeding as a complication of endoscopic choledocho-duodenal drainage using LAMS (Hot-Axios) in the treatment of distal stenosis of the common bile duct due to pancreatic head adenocarcinoma

Česká verze

Authors: Belica R. ¹; Kudlová D. ¹; Klepanec A. ²; Hoferica M. ²; Haršany J. ²; Rajec J. ¹; Habiňak M. ¹; Husťak R. ^1,3; Martínek J. ^1,3
Authors place of work: Klinika vnútorného lekárstva FN Trnava, Slovenská republika 2 Rádiologická klinika FN Trnava, Slovenská republika 3 Institut klinické a experimentální medicíny, Praha, Česká republika ¹
Published in the journal: Gastroent Hepatol 2021; 75(3): 207-212
Category: Kazuistika
doi: https://doi.org/10.48095/ccgh2021207

Summary

Introduction: Endoscopic transpapillary drainage is a common method of solving malignant biliary obstruction. An alternative to the transpapillary approach is endosonographically guided biliary drainage using a lumen-apposition stent, which can be used not only in case of ERCP failure. Case report: We describe our experience with endosonographically guided choledocho-duodenal drainage using a lumen--apposition stent, which was complicated by delayed hemobilia. Persistent and severe bleeding was successfully resolved by endovascular embolization using a spiral coiling. Conclusion: Endosonographically guided drainage using a lumen-apposition stent may, despite all advantages, be accompanied by serious complications, including significant bleeding. Therefore, the availability of an interventional radiology unit is appropriate.

Keywords:

obstructive jaundice – endoscopic retrograde cholangiopancreatography – Adenocarcinoma – Pancreas – cholestasis –endosonography

Zdroje

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