Endoscopic Ultrasound-Guided Biliary Drainage Using Self-Expandable Metal Stent for Malignant Biliary Obstruction

Figure 1

Endoscopic ultrasound-guided rendezvous technique. Under real-time EUS guidance, the dilated bile duct was punctured and a cholangiogram was obtained (a and b). A guidewire was advanced in an antegrade direction through the site of stenosis and across the papilla (c and d). Biliary cannulation was performed in the usual manner over the guidewire (e). Finally, an uncovered self-expandable metal stent was deployed for biliary drainage (f).

(a)

(b)

(c)

(d)

(e)

(f)