Gastroenterologie
a hepatologie

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 Husťak^1,3, Jan Martínek^1,3

+ Affiliation
¹ Klinika vnútorného lekárstva FN Trnava, Slovenská republika
² Rádiologická klinika FN Trnava, Slovenská republika
³ Institut klinické a experimentální medicíny, Praha

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, obstructive jaundice, adenokarcinóm

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