Transbiliary intravascular ultrasound-guided diagnostic biopsy of an inaccessible pancreatic head mass.
Percutaneous image-guided biopsies of pancreatic malignancies may prove challenging and nondiagnostic due to a variety of anatomic considerations. For patients with complex post-surgical anatomy, such as a Roux-en-Y gastric bypass, diagnosis via endoscopic ultrasound with fine-needle aspiration may not be possible because of an inability to reach the proximal duodenum. This report describes the first diagnostic case of transbiliary intravascular ultrasound-guided biopsy of a pancreatic head mass in a patient with prior Roux-en-Y gastric bypass for which a diagnosis could not be achieved via percutaneous and endoscopic approaches. Transbiliary intravascular ultrasound-guided biopsy resulted in a diagnosis of pancreatic adenocarcinoma, allowing the initiation of chemotherapy.
['Chick|Jeffrey Forris Beecham|JFB|', 'Roush|Benjamin B|BB|', 'Khaja|Minhaj S|MS|', 'Prohaska|Dennis|D|', 'Cooper|Kyle J|KJ|', 'Saad|Wael E|WE|', 'Srinivasa|Ravi N|RN|']
Transbiliary Pancreatic malignancy Intravascular ultrasound-guided biopsy Interventional radiology Pancreatic cancer Pancreatic mass Transhepatic