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Treatment of EUS (Endoscopic ultrasound) guided choledochoduodenostomy in a 65 year male

EUS (Endoscopic ultrasound) guided choledochoduodenostomy in a 65 year male had
1.obstructive jaundice
2.carcinoma head of pancreas
3. Blocked duodenum due to tumour infiltration

ERCP not feasible due to duodenal obstruction

EUS guided direct puncture from D1 and CBD metal stenting is better than PTBD performed routinely as

1. EUS procedure is less morbid compared to PTBD

2. EUS leads to internal drainage which PTBD cannot.

3. Acceptable more by patient and relatives compared to PTBD which has external drainage.