Endoscopic ultrasound-guided choledochoduodenostomy vs. transpapillary stenting for distal biliary obstruction

Kawakubo, Kazumichi; Kawakami, Hiroshi; Kubota, Yoshimasa; Kawahata, Shuhei; Kubo, Kimitoshi; Sakamoto, Naoya

doi:10.1055/s-0034-1393179

Cited by 49 publications

(61 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One study at a tertiary care center found that EUS-BD was required by only three (0.6%) of 524 patients with a native papilla undergoing therapeutic ERCP, concluding that EUS-BD should not replace good ERCP techniques. 74 Similar results were observed in another retrospective study comparing EUS-BD and ERCP. 73 A retrospective comparative cohort study comparing the clinical efficacy and safety of EUS-CDS and ERCP as first-line treatment for distal malignant biliary obstruction in 82 patients (26 EUS-CDS, 56 ERCP) found that mean procedure time was significantly shorter with EUS-CDS than with ERCP, although their clinical success and adverse event rates were similar.…”

Section: Eus-bd Versus Ercpsupporting

confidence: 83%

Recent advances in endoscopic ultrasound‐guided biliary drainage

Minaga

Kitano

2017

Digestive Endoscopy

View full text Add to dashboard Cite

Endoscopic ultrasound-guided biliary drainage (EUS-BD) is increasingly used as an alternative in patients with biliary obstruction who fail standard endoscopic retrograde cholangiopancreatography (ERCP). The two major endoscopic approach routes for EUS-BD are the transgastric intrahepatic and the transduodenal extrahepatic approaches. Biliary drainage can be achieved by three different methods, transluminal biliary stenting, transpapillary rendezvous technique, and antegrade biliary stenting. Choice of approach route and drainage method depends on individual anatomy, underlying disease, and location of the biliary stricture. Recent meta-analyses have revealed that cumulative technical success and adverse event rates were 90-94% and 16-23%, respectively. Development of new dedicated devices for EUS-BD would help refine the technical aspects and minimize the possibility of complications, making it a more promising procedure.

show abstract

Section: Eus-bd Versus Ercpsupporting

confidence: 83%

Recent advances in endoscopic ultrasound‐guided biliary drainage

Minaga

Kitano

2017

Digestive Endoscopy

View full text Add to dashboard Cite

show abstract

“…The overall rate of adverse events in the EUS-HGS group is consistent with recent studies and illustrates the relatively good safety profile of EU-BD compared with ERCP, as shown by one recent study comparing the clinical efficacy and safety of EU-BD and ERCP for patients with distal malignant biliary obstruction. 30 …”

Section: Resultsmentioning

confidence: 99%

Endoscopic ultrasound-guided hepaticogastrostomy versus percutaneous transhepatic drainage for malignant biliary obstruction after failed endoscopic retrograde cholangiopancreatography: a retrospective expertise-based study from two centers

Sportes

Camus

Greget

et al. 2017

Therap Adv Gastroenterol

View full text Add to dashboard Cite

Background:Percutaneous transhepatic biliary drainage (PTBD) is widely performed as a salvage procedure in patients with unresectable malignant obstruction of the common bile duct (CBD) after failed endoscopic retrograde cholangiopancreatography (ERCP) or in case of surgically altered anatomy. Endoscopic ultrasound-guided hepaticogastrostomy (EU-HGS) is a more recently introduced alternative to relieve malignant obstructive jaundice. The aim of this prospective observational study was to compare the outcome, efficacy and adverse events of EU-HGS and PTBD.Methods:From April 2012 to August 2015, consecutive patients with malignant CBD obstruction who underwent EU-HGS or PTBD in two tertiary-care referral centers were included. The primary endpoint was the clinical success rate. Secondary endpoints were technical success, overall survival, procedure-related adverse events, incidence of adverse events, and reintervention rate.Results:A total of 51 patients (EU-HGS, n = 31; PTBD, n = 20) were included. Median survival was 71 days (range 25–75th percentile; 30–95) for the EU-HGS group and 78 days (range 25–75th percentile; 42–108) for the PTBD group (p = 0.99). Technical success was achieved in all patients in both groups. Clinical success was achieved in 25 (86%) of 31 patients in the EU-HGS group and in 15 (83%) of 20 patients in the PTBD group (p = 0.88). There was no difference in adverse events rates between the two groups (EU-HGS: 16%; PTBD: 10%) (p = 0.69). Four deaths within 1 month (two hemorrhagic and two septic) were considered procedure related (two in the EU-HGS group and two in the PTBD group). Overall reintervention rate was significantly lower after EU-HGS (n = 2) than after PTBD (n = 21) (p = 0.0001). Length of hospital stay was shorter after EU-HGS (8 days versus 15 days; p = 0.002).Conclusions:EU-HGS can be an effective and safe mini invasive-procedure alternative to PTBD, with similar success and adverse-event rates, but with lower rates of reintervention and length of hospitalization.

show abstract

“…Although surgical drainage is also an option when minimally invasive procedures fail, to our knowledge there are no studies directly comparing the outcomes of EUS-guided and surgical biliary drainage. In a recent study, EUS-guided biliary drainage was also comparable with conventional transpapillary ERCP drainage in terms of clinical success, procedural time, and adverse events, being even associated with a lower rate of pancreatitis [7]. However, this was a small single-center study and standard ERCP has a demonstrated high efficacy and safety profile with experienced operators and should be the first-line approach to biliary drainage.…”

Section: Discussionmentioning

confidence: 93%

Endoscopic Ultrasound-Guided Biliary Drainage in Two Patients with Difficult Biliary Access

Libânio

Giestas

Martı́nez-Ares

et al. 2017

GE Port J Gastroenterol

View full text Add to dashboard Cite

Introduction: Endoscopic retrograde cholangiopancreatography is the method of choice for biliary drainage, although in some cases standard biliary access is difficult or even impossible. Endoscopic ultrasound (EUS)-guided endoluminal procedures are an alternative in these cases, although experience with these techniques is still limited. Clinical Case: We present two cases of successful EUS-guided biliary drainage. In the first case, a hepaticogastrostomy was performed in a patient with stage IV gastric adenocarcinoma with obstructive jaundice due to compression of the hilum, where malignant gastric stenosis and previous palliative gastrojejunostomy precluded access to the second part of the duodenum. In the second case, a patient with a pancreatic head adenocarcinoma with duodenal invasion that precluded major papillae identification was submitted to a choledochoduodenostomy. Both procedures occurred without immediate or delayed adverse events, with technical and clinical success. Discussion: Although experience with EUS-guided biliary drainage is still limited, its efficacy and safety is favorable when compared with percutaneous and surgical drainage, and should be considered an alternative to these techniques where sufficient expertise exists.

show abstract

Endoscopic ultrasound-guided choledochoduodenostomy vs. transpapillary stenting for distal biliary obstruction

Abstract: EUS-CDS performed by expert endoscopists was associated with a short procedure time and no risk of pancreatitis, and would therefore be feasible as a first-line treatment for patients with distal malignant biliary obstruction.

Cited by 49 publications

References 26 publications

Recent advances in endoscopic ultrasound‐guided biliary drainage

Recent advances in endoscopic ultrasound‐guided biliary drainage

Endoscopic ultrasound-guided hepaticogastrostomy versus percutaneous transhepatic drainage for malignant biliary obstruction after failed endoscopic retrograde cholangiopancreatography: a retrospective expertise-based study from two centers

Endoscopic Ultrasound-Guided Biliary Drainage in Two Patients with Difficult Biliary Access

Contact Info

Product

Resources

About