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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2021; 75(3): 207–212. doi: 10.48095/ccgh2021207.

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

Roman Belica1, Denisa Kudlová1, Andrej Klepanec2, Matúš Hoferica2, Ján Haršány2, Ján Rajec1, Martin Habiňák1, Rastislav Husťak1,3, Jan Martínek1,3

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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

endosonography, pancreas, cholestáza, obštrukčný ikterus, adenokarcinóm

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Literature


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