Endoscopic ultrasound
Case report
71-year-old patient with a history of duodenal carcinoma and tumor resection with duodenojejunostomy. Approximately one year after resection, ultrasound reveals intra- and extrahepatic cholestasis with cholangitis. ERCP shows a reoccurence of the tumor with an exophytic tumor structure in the papillary region; probing of the papilla is unsuccessful. The following day, choledochoduodenostomy with insertion of a lumen-apposing metal stent (LAMS) was performed under endosonographic guidance. This resulted in the drainage of a large amount of cloudy bile. The follow-up examination after three days shows pneumobilia (-> thus proving the correct position of the stent).
