New methodsClinical endoscopyPreliminary report on a new hybrid metal stent for EUS-guided biliary drainage (with videos)
Section snippets
Methods
We obtained permission from the Institutional Review Board of Asan Medical Center and performed a prospective data collection. A total of 27 consecutive patients were included between September 2011 and August 2013. Our inclusion criteria were (1) the presence of a malignant biliary obstruction and (2) failed conventional ERCP stenting. Our exclusion criteria were (1) advanced heart or lung disease precluding adequate sedation and (2) a lack of informed consent. These 27 patients included 13
Results
The patient baseline characteristics and outcomes of EUS-BD are summarized in Table 1. EUS-HG was performed in 10 patients, and EUS-CD was performed in 17 patients. The technical success rate of EUS-BD with the hybrid metal stent was 100% (27/27), and clinical success was achieved in 96.3% (26/27) of the cases. The median procedure time was 20.0 minutes (range 15-40 minutes). One patient who had undergone EUS-CD had jaundice that failed to improve after 3 days, and a repeat endoscopy revealed
Discussion
EUS-BD is increasingly used as a minimally invasive alternative to percutaneous drainage or surgery after a failed ERCP. Although previous studies suggested that EUS-BD is feasible and effective, concerns have been raised regarding the potential risks of serious adverse events, particularly stent-related adverse events.9 For example, proximal stent migration caused by a shortening of the metal stent after deployment may lead to bile leakage into the peritoneal cavity through the migrated stent
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DISCLOSURE: All authors disclosed no financial relationships relevant to this article.