Endoscopic transduodenal drainage of an abscess arising after EUS-FNA of a duodenal GI stromal tumor

Abstract

compared with fluoroscopic-guided laser or electrohydraulic lithotripsy (EHL) by ERCP, PDCS-L with a standard endoscope with a 4-way bending system can be safely performed for the EHL, capture, and removal of bile duct stones under visual control. Second, because a standard upper endoscope is commonly available, PDCS-L with a standard upper endoscope would likely be a feasible procedure in most endoscopy centers. However, PDCS-L with a standard upper endoscope can only be performed on a subset of patients with difficult CBD stones, due to variable successful intubation rates to the bile duct. In a previous series, the successful intubation rate to the bile duct for PDCS by an upper endoscope (tip diameter 9 mm) was about 71% (10/14). In summary, PDCS-L with a standard upper endoscope may be feasible and effective for difficult bile duct stones. Further experience with this technique will define its role in the treatment of the subset of patients who have difficult CBD stones. Moreover, this approach will not become the standard of care until more data are available from multiple centers confirming its successful outcome.