A nasobiliary catheter landmark technique for endoscopic ultrasound-guided gallbladder drainage in patients with Billroth II anatomy: A case series

Description

Inho Lee and colleagues use a nasal bile catheter as a road marker to drain gallbladders in patients whose stomach surgery rerouted the gut, reporting a 2026 case series. Ultrasound-guided gallbladder drainage treats acute gallbladder inflammation in patients too frail for surgery. After Billroth II reconstruction, though, the usual scope struggles to find the duodenum. Their first described patient, an 82-year-old woman with prior stomach cancer surgery, arrived with a swollen, inflamed gallbladder and high surgical risk.

A slim colonoscope first carried a fine catheter deep into the duodenum through the surgical junction, then withdrew and left the catheter behind. The ultrasound scope followed that visible landmark into place. Drainage used a metal stent opening a channel between gut and gallbladder. Four weeks later, scope checks showed stones fully cleared, and the metal stent was swapped for a plastic one. The authors offer the landmark trick for like anatomy.

Catalog record

Source: https://europepmc.org/article/MED/PMC13441511