Endoscopic ultrasonography‐guided antegrade treatment for bile duct stone with multi‐step approach in a patient with surgically altered anatomy

Iwashita, Takuji; Uemura, Shiro; Shimizu, Masahito

doi:10.1111/den.13021

Cited by 7 publications

(8 citation statements)

References 5 publications

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“…This concept also allows multi-step antegrade approach through the HGS route, which might be an expanded indication of EUS-guided procedures for management of complicated biliary diseases such as benign strictures or large biliary stones. [27][28][29] Combination of EUS-ABS and HGS also requires further evaluation in patients with surgically altered anatomy and comparison with other techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Although SEMS was used for both ABS and HGS in this study, 25 application of a specially designed plastic stent for HGS, which was reported with high technically feasibility and safety, 26 might be useful to keep access route for possible repeat procedures in cases of recurrent stent obstruction, since removal and exchange should be easier with the plastic stent. This concept also allows multi‐step antegrade approach through the HGS route, which might be an expanded indication of EUS‐guided procedures for management of complicated biliary diseases such as benign strictures or large biliary stones 27–29 . Combination of EUS‐ABS and HGS also requires further evaluation in patients with surgically altered anatomy and comparison with other techniques.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic ultrasound guided–antegrade biliary stenting vs percutaneous transhepatic biliary stenting for unresectable distal malignant biliary obstruction in patients with surgically altered anatomy

Iwashita

Uemura

Mita

et al. 2020

J Hepato Biliary Pancreat

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Background/Purpose: Unresectable distal malignant biliary obstruction (DMBO) in patients with surgically altered anatomy is traditionally managed with percutaneous transhepatic biliary drainage (PTBD) and stenting because the anatomical features complicate the endoscopic approach to the biliary orifice. EUS-guided approaches recently emerged as alternative treatments; however, limited data comparing the procedures are available. The aim of this study was to compare EUS-antegrade biliary stenting (ABS) with PTBD for DMBO in patients with surgically altered anatomy. Methods: The medical records of patients who underwent EUS-ABS or PTBD for the management of DMBO and had a history of upper intestinal surgery at two tertiary centers between 2007 and 2019 were retrospectively evaluated. The study outcomes were technical, clinical, and internalization success rates and adverse event rates. Results: Of the 64 enrolled patients, 35 underwent EUS-ABS and 29 had PTBD. Basic characteristics including age, sex, performance status, primary malignancy, and reconstruction method did not differ significantly between groups. The technical, clinical, and internalization success rates in the EUS-ABS and PTBD groups were 97.1% vs 96.6% (P = 1.00), 97.1% vs 93.1% (P = .586), and 97.1% vs 75.9% (P = .01), respectively. The adverse event rate was 11.4% vs 27.6% (P = .119). No significant long-term difference was seen in time to recurrent biliary obstruction and survival. Multivariate analysis confirmed EUS-ABS was not an independent risk factor for survival. Conclusions: Similar to PTBD, EUS-ABS can effectively and safely manage DMBO in patients with surgically altered anatomy. Further well-designed trials are warranted to confirm these findings. K E Y W O R D S antegrade technique, ERCP, EUS-AG, EUS-BD, EUS-guided biliary drainage | 969 IWASHITA eT Al. How to cite this article: Iwashita T, Uemura S, Mita N, et al. Endoscopic ultrasound guided-antegrade biliary stenting vs percutaneous transhepatic biliary stenting for unresectable distal malignant biliary obstruction in patients with surgically altered anatomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound guided–antegrade biliary stenting vs percutaneous transhepatic biliary stenting for unresectable distal malignant biliary obstruction in patients with surgically altered anatomy

Iwashita

Uemura

Mita

et al. 2020

J Hepato Biliary Pancreat

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“…The creation of a mature fistula between the IHBD and the upper intestine can expand the applicability of techniques and devices to manage difficult bile duct stones, such as large or multiple stones. Several reports have described the use of a mechanical lithotripter 36,37 or peroral cholangioscopy (POCS) with electrohydraulic lithotripsy (EHL) [38][39][40] for large stones (Fig. 9).…”

Section: Current Topics In Eus-ag For Bdsmentioning

confidence: 99%

Current status of endoscopic ultrasound‐guided antegrade intervention for biliary diseases in patients with surgically altered anatomy

Iwashita

Uemura

Tezuka

et al. 2022

Digestive Endoscopy

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Endoscopic management of biliary diseases in patients with surgically altered anatomy can be challenging because the altered anatomy makes it difficult to insert an endoscope into the biliary orifice. Even if insertion is feasible, the worse maneuverability of the endoscope and the restriction in available devices and techniques could complicate the procedure. Recently, endoscopic ultrasound‐guided antegrade intervention (EUS‐AG) has been reported as a useful management method for biliary diseases, especially in patients with surgically altered anatomy. In EUS‐AG, the biliary disease is managed in an antegrade fashion through a temporal fistula created under EUS guidance between the intrahepatic biliary duct and upper intestine. In this article, we reviewed the current status of EUS‐AG for each biliary diseases, malignant biliary obstruction, bile duct stones, and benign biliary stricture in patients with surgically altered anatomy.

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“…EUS‐AG is an efficient procedure resolving failed balloon enteroscopy in patients with altered gastrointestinal anatomy (AGA) . This procedure can be performed not only for stone extraction in a single session but also through a multi‐step approach, depending on the patient's general condition . Single‐step EUS‐AG is an optional procedure for resolving pancreatobiliary obstruction in emergent cases of AGA due to a small BD stone.…”

Section: Brief Explanationmentioning

confidence: 99%

Emergent endoscopic ultrasonography‐guided antegrade treatment for acute biliary pancreatitis in a patient with altered gastrointestinal anatomy

Hashimoto

Fujita

Ido

2019

Digestive Endoscopy

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Endoscopic ultrasonography‐guided antegrade treatment for bile duct stone with multi‐step approach in a patient with surgically altered anatomy

Cited by 7 publications

References 5 publications

Endoscopic ultrasound guided–antegrade biliary stenting vs percutaneous transhepatic biliary stenting for unresectable distal malignant biliary obstruction in patients with surgically altered anatomy

Endoscopic ultrasound guided–antegrade biliary stenting vs percutaneous transhepatic biliary stenting for unresectable distal malignant biliary obstruction in patients with surgically altered anatomy

Current status of endoscopic ultrasound‐guided antegrade intervention for biliary diseases in patients with surgically altered anatomy

Emergent endoscopic ultrasonography‐guided antegrade treatment for acute biliary pancreatitis in a patient with altered gastrointestinal anatomy

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