Efficacy and Safety of Endoscopic Ultrasound-guided Choledochoduodenostomy

Mohan, Babu P.; Shakhatreh, Mohammed; Garg, Rajat; Ponnada, Suresh; Navaneethan, Udayakumar; Adler, Douglas G.

doi:10.1097/mcg.0000000000001167

Cited by 45 publications

(44 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our reported rates of the adverse events with EUS-BD are the key findings of this analysis, as studies vary widely in the reported rates of adverse events with EUS-BD. A recently published meta-analysis of studies [35] reporting on EUS-guided CDD reported an overall pooled adverse event rate of 14.5% with EUS-CDD and 20.9% with EUS-HG. [35] The overall adverse events were higher as compared to ERCP, which are reported to be 9.8% as per Enochsson et al [1] Our analysis of the subgroups, based on the study type (prospective vs. retrospective) and study center (single vs. multi), showed comparable technical success and clinical success rates in EUS-BD.…”

Section: Discussionmentioning

confidence: 99%

“…A recently published meta-analysis of studies [35] reporting on EUS-guided CDD reported an overall pooled adverse event rate of 14.5% with EUS-CDD and 20.9% with EUS-HG. [35] The overall adverse events were higher as compared to ERCP, which are reported to be 9.8% as per Enochsson et al [1] Our analysis of the subgroups, based on the study type (prospective vs. retrospective) and study center (single vs. multi), showed comparable technical success and clinical success rates in EUS-BD. We, however, noticed a reduction in the heterogeneity I 2 values with prospectively done studies as compared to the retrospective ones, suggesting that this could be one another contributing factor to our overall observed heterogeneity.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

EUS-guided biliary drainage: A systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

ERCP is the current procedure of choice for patients with jaundice caused by biliary obstruction. EUS-guided biliary drainage (EUS-BD) has emerged as an alternative to ERCP in patients requiring biliary drainage. The aim of the study was to conduct a systematic review and meta-analysis to report the overall efficacy and safety of EUS-BD. We conducted a comprehensive search of several databases including PubMed, EMBASE, Web of Science, Google Scholar, and LILACS databases (earliest inception to June 2018) to identify studies that reported EUS-BD in patients. The primary outcome was to look at the technical and clinical success of the procedure. The secondary analysis focused on calculating the pooled rate of re-interventions and all adverse-events, along with the commonly reported adverse-event subtypes. Twenty-three studies reporting on 1437 patients were identified undergoing 1444 procedures. Majority of the patient population were male (53.86%), with an average age of 67.22 years. The pooled technical success rates and clinical success rates were 91.5% (95% confidence interval [CI]: 87.7-94.2, I 2 = 76.5) and 87% (95% CI: 82.3-90.6, I 2 = 72.4), respectively. The total adverse event rates were 17.9% (95% CI: 14.3-22.2, I 2 = 69.1). Subgroup analysis of three major individual adverse events was bile leak: 4.1% (2.7-6.2, I 2 = 46.7), stent migration: 3.9% (2.5-6.2, I 2 = 43.5), and infection: 3.8% (2.8-5.1, I 2 = 0) Substantial heterogeneity was noted in the analysis. EUS-BD has high technical and clinical success rate and hence a very effective procedure. Concerns about publication bias exist. Careful consideration should be given to the adverse events and weighing the risks and benefits of the alternative nonsurgical/ surgical approaches.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

EUS-guided biliary drainage: A systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…According to a recent meta-analysis including 572 patients [11], the pooled rate of all adverse events was 0.136 (95% CI, 0.097-0.188; P = 0.01) with moderate heterogeneity (I = 56.9), and pooled rates were 4.2% for cholangitis, 4.1% for bleeding, 3.7% for bile leakage, and 2.9% for perforation. On subgroup analysis, the pooled rate of adverse events with the use of lumen-apposing metal stents was 9.3% (95%CI, 4.8-17.3%).…”

Section: Clinical Resultsmentioning

confidence: 99%

EUS-Guided Biliary Drainage

Ogura¹,

Higuchi²

2020

Advanced Endoscopy

View full text Add to dashboard Cite

Endoscopic ultrasound-guided biliary drainage (EUS-BD) has been developed as an alternative method for failed endoscopic retrograde cholangiopancreatography (ERCP). EUS-BD can be divided into two main approach routes, such as transgastric or transduodenal approach. Also, EUS-guided hepaticogastrostomy, choledochoduodenostomy (CDS), and gallbladder drainage (GBD) have been reported. In this chapter, we described technical tips for each basic technique, including literature review. As advanced technique of EUS-BD, antegrade stone removal has been reported. More recently, electrohydraulic lithotripsy for bile duct stones under transluminal cholangioscopy guidance, hepaticojejunostomy stricture dilation through EUS-hepaticogastrostomy (HGS) route, or EUS-guided gastrojejunostomy has been reported. Although EUS-BD has various potential as treatment technique, treatment method should be selected for each patient's conditions.

show abstract

“…In patients showing complications of duodenal obstruction due to malignant tumor or surgically altered anatomy, ERCP itself might prove challenging. Recently, endoscopic ultrasound (EUS)-guided drainage methods have been developed, particularly for biliary drainage such as choledochoduodenostomy, hepaticogastrostomy, or gallbladder drainage [18][19][20][21][22]. In addition, EUS-guided pancreatic duct drainage (PD) has been reported [23][24][25][26][27].…”

Section: Endoscopic Ultrasound-guided Pancreatic Duct Drainagementioning

confidence: 99%

Innovation in Pancreatic Stents

Ogura

Higuchi

2020

Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy

View full text Add to dashboard Cite

Benign main pancreatic duct (MPD) stricture is mainly caused by chronic pancreatitis (CP). Surgical or endoscopic approaches can be selected for treatment. However, although long-term results of surgical treatment are favorable according to previous studies, the treatment is invasive. Therefore, in clinical situations, pancreatic duct stent insertion is often considered as a first-line treatment. Kinds of pancreatic stent are classified as two main categories, plastic and metallic. Also, as kinds of endoscopic approach, endoscopic retrograde cholangiopancreatography (ERCO) is gold standard, however, if endoscopic insertion into ampulla of Vater, this method is challenging. As novel approach technique, endoscopic ultrasound (EUS)-guided access has been reported. This chapter reviews previous studies and discusses the roles and innovations of pancreatic stents.

show abstract

Efficacy and Safety of Endoscopic Ultrasound-guided Choledochoduodenostomy

Cited by 45 publications

References 37 publications

EUS-guided biliary drainage: A systematic review and meta-analysis

EUS-guided biliary drainage: A systematic review and meta-analysis

EUS-Guided Biliary Drainage

Innovation in Pancreatic Stents

Contact Info

Product

Resources

About