Endoscopic ultrasound-guided choledochoduodenostomy after a failed or impossible ERCP

Soler, Antonio Palanca; Delgado, Alberto Álvarez; Pérez, María Concepción; Velasco-Guardado, Antonio; Prieto, Héctor Marcos; Pérez, Antonio Rodríguez

doi:10.17235/reed.2018.5040/2017

Cited by 8 publications

(2 citation statements)

References 11 publications

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“…In addition, it could create an anastomosis between the biliary and alimentary lumen to allow biliary drainage (13,14). This could be a valid option after ERCP failure (15,16).…”

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasound-guided biliary drainage for distal malignant biliary obstruction: a prospective 3-year multicenter Egyptian study

Ragab¹,

Abdel-Hameed²,

Gouda³

et al. 2023

AGEB

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Background/Aim: Malignant biliary obstruction (MBO) is often diagnosed at late stages with mostly unresectable lesions. Recently, EUS-guided biliary drainage (EUS-BD) has gained wide acceptance and appears to be a feasible and safe backup option after ERCP failure in such patients. Herein, we aimed to represent a 3-year multi-center Egyptian experience in the application of this challenging procedure for distal MBO as a salvage technique after failed ERCP. Patients and methods: This was a prospective multi-center study of patients underwent EUS-BD for distal MBO in the duration between December 2018 and December 2021, after ERCP failure. Results: Ninety-one patients (59 males, median age: 61 years) were included in the study. EUS-guided extrahepatic approach including choledocho-duodenostomy (CDS) was done for 48 patients (52.8%), followed by choledecho-antrostomy (CAS) in 4 patients (4.4%). The intrahepatic approach included hepaticogastrostomy (HGS) for 35 patients (38.5%) and antegrade stenting (AG) stenting in 2 patients (2.2%), while Rendezvous (RV) approach was performed in 2 patients (2.2%). Technical and Clinical success were achieved in the majority of cases; 93.4% and 94.1% respectively. Adverse events occurred in 13.2% of patients which were mostly mild (8.2%) to moderate (2.4%). Only one patient died within 48h after the procedure with progression of preceding sepsis and organ failure. Conclusion: EUS-BD is a feasible option, even in developing countries, after a failed ERCP, and it is a relatively safe option in patients with MBO once experienced team and resources were present. Majority of cases in our study have achieved technical and clinical success with relatively low incidence of adverse events

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“…In addition, it could create an anastomosis between the biliary and alimentary lumen to allow biliary drainage (13,14). This could be a valid option after ERCP failure (15,16).…”

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasound-guided biliary drainage for distal malignant biliary obstruction: a prospective 3-year multicenter Egyptian study

Ragab¹,

Abdel-Hameed²,

Gouda³

et al. 2023

AGEB

View full text Add to dashboard Cite

show abstract

“…As reviewed in the literature, the performance of endoscopic ultrasound-guided choledocoduodenostomy has an approximate percentage of adverse events of 16%, mainly consisting of infection, pneumoperitoneum, biliary leakage, bleeding, abdominal pain, perforation and stent migration, the most frequently reported being the Pneumoperitoneum with conservative management and good evolution of the patient [ 4 , 7 ], on the other hand the use of Doppler implies a very convenient weapon for the endoscopist when discarding the presence of vascular structure and avoiding complication [ 5 ], there are still reports of cases such as Mangas-Sanjuan and collaborators in which they present a case of accidental puncture of the portal vein at the time of performing a USE-CD, a complication that they managed to resolve by the same route obtaining control of bleeding and finally with clinical and technique success on Bile drainage [ 5 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound (EUS) guided choledocoduodenostomy in a patient with irresecable pancreas cancer and biliar obstruction using a luminal apposing metal stent (LAMS)

Pinto-Carta

Solano

Cabrera

et al. 2020

International Journal of Surgery Case Reports

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Endoscopic biliary drainage in unresectable biliary obstruction: the role of endoscopic ultrasound-guidance in a cohort study

et al. 2019

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Endoscopic ultrasound-guided choledochoduodenostomy after a failed or impossible ERCP

Abstract: Introduction: Endoscopic ultrasound-guided biliary drainage (EUS-BD) is an alternative

Cited by 8 publications

References 11 publications

Endoscopic ultrasound-guided biliary drainage for distal malignant biliary obstruction: a prospective 3-year multicenter Egyptian study

Endoscopic ultrasound-guided biliary drainage for distal malignant biliary obstruction: a prospective 3-year multicenter Egyptian study

Endoscopic ultrasound (EUS) guided choledocoduodenostomy in a patient with irresecable pancreas cancer and biliar obstruction using a luminal apposing metal stent (LAMS)

Endoscopic biliary drainage in unresectable biliary obstruction: the role of endoscopic ultrasound-guidance in a cohort study

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