Endoscopic Ultrasound-Guided Antegrade Stent Placement in Patients with Failed ERCP as a Modality of Preoperative and Palliative Biliary Drainage

Sundaram, Sridhar; Mane, Kiran; Patil, Prachi; Rathod, Raosaheb; Jain, Aayush; Tyagi, Unique; Mehta, Shaesta

doi:10.1007/s10620-022-07655-w

Cited by 9 publications

(5 citation statements)

References 31 publications

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“…Further study is warranted in this regard. PBD using EUS‐AGS is a useful option 21 . However, even with an uncovered MS, there remains a risk of pancreatitis in the absence of pancreatic duct obstruction, which should be avoided preoperatively, and re‐intervention in the case of RBO is more difficult than other techniques.…”

Section: Discussionmentioning

confidence: 99%

“…A literature search yielded only three previous reports on EUS-BD performed for PBD that included at least five cases (Table 4). [19][20][21] If EUS-CDS is performed, the proximity of the created fistula to the hilar portion may negatively impact bile duct resection and anastomosis with the jejunum due to inflammation in the region of the porta hepatis. Recurrent tract seeding associated with bile juice leakage from the bile ducts close to the malignant stricture is also a concern, especially in patients with bile duct cancer.…”

Section: Discussionmentioning

confidence: 99%

“…PBD using EUS-AGS is a useful option. 21 However, even with an uncovered MS, there remains a risk of pancreatitis in the absence of pancreatic duct obstruction, which should be avoided preoperatively, and re-intervention in the case of RBO is more difficult than other techniques. Therefore, we consider EUS-HGS to be more suitable for PBD because there is less risk of interruption of the surgical procedure and less concern about cholangitis as a result of reflux of intestinal bacteria and food residue than with EUS-CDS or EUS-AGS.…”

Section: Discussionmentioning

confidence: 99%

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Clinical feasibility of endoscopic ultrasound‐guided biliary drainage for preoperative management of malignant biliary obstruction (with videos)

Mukai

Itoi

Tsuchiya

et al. 2022

J Hepato Biliary Pancreat

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Surgical resection continues to be the only curative treatment for malignant hepatobiliary and pancreatic tumors. These tumors are often associated with obstructive jaundice as a result of distal or hilar biliary stricture, which can adversely affect surgical outcomes by causing liver damage, coagulopathy, or cholangitis. 1 Therefore, preoperative biliary drainage (PBD) has traditionally been performed to decompress the bile duct. 2,3 Although the benefit of PBD remains controversial when jaundice is mild and early surgical resection is possible, PBD is often required in daily clinical practice. 4,5 Endoscopic transpapillary drainage by endoscopic retrograde cholangiopancreatography (ERCP) is the first-line

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical feasibility of endoscopic ultrasound‐guided biliary drainage for preoperative management of malignant biliary obstruction (with videos)

Mukai

Itoi

Tsuchiya

et al. 2022

J Hepato Biliary Pancreat

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“…The success rate of EUS-AGS is inferior to that of EUS-HGS or EUS-CDS owing to the difficulty of guidewire passage and stent delivery system insertion across the strictures. In a recent large retrospective study on EUS-AGS in 54 patients, 90 indication was palliative in 34 (62.9%) patients and preoperative in 20 (37%) patients. Technical success of EUS-AG was 88.7%.…”

Section: Recommendation 14mentioning

confidence: 99%

Society of Gastrointestinal Endoscopy of India Consensus Guidelines on Endoscopic Ultrasound-Guided Biliary Drainage: Part I (Indications, Outcomes, Comparative Evaluations, Training)

Rai

Udawat

Chowdhary

et al. 2023

Journal of Digestive Endoscopy

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Endoscopic management of bile duct obstruction is a key aspect in gastroenterology practice and has evolved since the first description of biliary cannulation by McCune et al in 1968. Over many decades, the techniques and accessories have been refined and currently, the first-line management for extrahepatic biliary obstruction is endoscopic retrograde cholangiopancreaticography (ERCP). However, even in expert hands the success rate of ERCP reaches up to 95%. In almost 4 to 16% cases, failure to cannulate the bile duct may necessitate other alternatives such as surgical bypass or more commonly percutaneous transhepatic biliary drainage (PTBD). While surgery is associated with high morbidity and mortality, PTBD has a very high reintervention and complication rate (∼80%) and poor quality of life. Almost parallelly, endoscopic ultrasound (EUS) has come a long way from a mere diagnostic tool to a substantial therapeutic option in various pancreatico-biliary diseases. Biliary drainage using EUS-guidance (EUS-BD) has gained momentum since the first report published by Giovannini et al in 2001. The concept of accessing the bile duct through a different route than the papilla, circumventing the shortcomings of PTBD and sometimes bypassing the actual obstruction have enthused a lot of interest in this novel strategy. The three key methods of EUS-BD entail transluminal, antegrade, and rendezvous approach. Over the past decade, with growing experience, EUS-BD has been found to be equivalent to ERCP or PTBD for malignant obstruction with better success rates.EUS-BD, albeit, is not devoid of adverse events and can carry fatal adverse events. However, neither the technique of EUS-BD, nor the accessories and stents for EUS-BD have been standardized.Additionally, different countries and regions have different availability of the accessories making generalizability a difficult task. Thus, technical aspects of this evolving therapy need to be outlined. For these reasons, the Society of Gastrointestinal Endoscopy India deemed it appropriate to develop technical consensus statements for performing safe and successful EUS-BD.

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“…Primary outcome was technical success defined by successful stent placement across the papilla. Secondary outcomes were factors associated with technical failure 1 .…”

mentioning

confidence: 99%

Predictors of failure of endoscopic ultrasound guided antegrade biliary stent placement: experience from a tertiary care cancer center

Sundaram,

Kiran,

Unique

et al. 2023

ESGE Days 2023

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Endoscopic Ultrasound-Guided Antegrade Stent Placement in Patients with Failed ERCP as a Modality of Preoperative and Palliative Biliary Drainage

Cited by 9 publications

References 31 publications

Clinical feasibility of endoscopic ultrasound‐guided biliary drainage for preoperative management of malignant biliary obstruction (with videos)

Clinical feasibility of endoscopic ultrasound‐guided biliary drainage for preoperative management of malignant biliary obstruction (with videos)

Society of Gastrointestinal Endoscopy of India Consensus Guidelines on Endoscopic Ultrasound-Guided Biliary Drainage: Part I (Indications, Outcomes, Comparative Evaluations, Training)

Predictors of failure of endoscopic ultrasound guided antegrade biliary stent placement: experience from a tertiary care cancer center

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