Original articleClinical endoscopyEUS-guided biliary drainage with transluminal stenting after failed ERCP: predictors of adverse events and long-term results
Section snippets
Patients
From June 2008 to May 2010, a total of 2589 ERCPs were carried out in a 2600-bed, tertiary-care referral hospital by a single experienced endoscopist (D.H.P.). In this study period, a total of 1423 cases required biliary decompressions for benign or malignant biliary obstruction. Of the 1423 patients, 60 consecutive patients (4.2%, 51 malignant biliary obstructions and 9 benign biliary obstructions) were candidates for alternative techniques for biliary decompression because of failed ERCP. In
Outcomes of EUS-BDS
The overall technical success rate of EUS-BDS was 96.5% (55/57, analyzed in an intention-to-treat fashion; 31 EUS-HGS and 26 EUS-CDS; 51 malignant and 6 benign biliary obstructions). In malignant biliary obstruction (n = 51), the EUS-guided rendezvous technique was not routinely attempted initially, but conversion to this technique was performed in 2 patients with pancreatic cancer during the EUS-CDS procedure because of insufficient bile duct dilatation for transluminal stenting on EUS-guided
Discussion
To date, EUS-BD has comprised EUS-HGS, EUS-CDS, and rendezvous techniques. EUS-HGS and EUS-CDS may have advantages over the EUS-guided rendezvous technique. First, EUS-HGS can be performed on patients with surgically altered anatomy or duodenal invasion.2, 3, 6 A major limitation of the rendezvous technique is that it can be attempted only in patients in whom the papilla is accessible by endoscopy.6 Second, for the EUS-guided rendezvous technique, a guidewire should traverse the major duodenal
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Cited by (241)
Utilization of a Small-Caliber Balloon Dilator for Endoscopic Ultrasound-Guided Hepaticogastrostomy Creation: Case Series
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2024, Gastrointestinal Endoscopy Clinics of North AmericaAdverse events with EUS-guided biliary drainage: a systematic review and meta-analysis
2023, Gastrointestinal EndoscopyEndoscopic ultrasound guided biliary interventions
2022, Best Practice and Research: Clinical GastroenterologyCitation Excerpt :Park et al. evaluated risk factors for adverse events associated with EUS-BD in 57 consecutive patients and observed a significant association of post-procedure adverse events with fistula dilation using a needle-knife (NK) electrocautery compared with graded dilation (9/27 [33%] vs 2/28 [7%], p = 0.02). They recommended avoiding of NK in EUS-BD [56]. Honjo et al. compared ultra-tapered mechanical (n = 26) and electrocautery (n = 23) (control) dilators for fistula dilation during EUS-HGS.
Endoscopic Ultrasound–Guided Biliary Interventions
2022, Gastrointestinal Endoscopy Clinics of North AmericaCitation Excerpt :Several stents have been designed specific to EUS therapies, which have been summarized in Tables 3 and 4. alOutcomes and complications in EUS-BD have been well documented in sever large studies as summarized in Table 5.21,23–25,29–40 EUS-BD has a similar profile of adverse events to ERCP.
Relief of jaundice in malignant biliary obstruction: When should we consider endoscopic ultrasonography-guided hepaticogastrostomy as an option?
2022, Hepatobiliary and Pancreatic Diseases International
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
If you would like to chat with an author of this article, you may contact Dr Park at [email protected].
See CME section; p. 1376.