EUS Guided Choledochoduodenostomy

In EUS guided choledocho-duodenostomy, under endoscopic sonography guidance, a wire is placed across the duodenal wall into the common bile duct, followed by a “cystotome”, a device with cautery current to create a hole in the duodenum and the bile duct wall, followed by placement of a metal stent across the duodenum into the bile duct to bypass the blockage. This allows free flow of bile out of the bile duct and jaundice improves. This is a painless procedure and performed under sedation.