EUS FNI cholangiography

Is EUS FNI cholangiography or pancreatography possible? When are they indicated? 

  • Yes. EUS-guided pancreatography and cholangiography can be easily achieved because of the ability of EUS to image the common bile duct and pancreatic duct. Injection of contrast into the ducts can be performed. These techniques are used when ERCP fails to gain access.
  • This might be an issue in the case of tumor obstruction or surgically altered anatomy (Billroth II or gastrectomy with Roux-en-Y).
  • EUS-guided transduodenal and transgastric placement of the stents into the pancreatic duct or biliary system is possible.
  • This can be a viable alternative to percutaneous biliary drainage. EUS-guided pancreatic duct drainage has been performed via a transgastric route (pancreaticogastrostomy) to alleviate pain associated with chronic pancreatitis and ductal disruption and obstruction.
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