EUS-guided biliary drainage: a case series

Endoscopic ultrasound guided biliary drainage

“…91% (1 failure [25] 4 100% 100% CDS 4 7 F PS 3 Peritonitis and bleeding 1 Occlusion 1 5 F NBD 1 Tarantino et al [23] 8 100% 100% CDS 4 10 F PS ------RTPS 4 Yamao et al [24] 5 100% 100% CDS 5 7-8.5 F PS Pneumoperitoneum 1 Migration 1 Occlusion 5 Kahaleh and Maranki et al [10,12,16,29] Park et al [28] 14 100% 100% CDS 5 FCSEMS Pneumoperitoneum 2 Migration 1 HGS 9 Lai et al [32] 1 100% 100% CDS 1 10 F PS --------Martins et al [33] 1 100% 100% HGS PCSEMS ----Migration 1 (dead) Park et al [34] 5 100% 100% HGS FCSEMS ------Nguyen-Tang et al [35] 5 100% 100% TPSA USEMS ------Kim et al [26] 15 80% (3 failure) 100% RTPS USEMS 8 ------10 F PS 4 Belletrutti et al [36] 1 100% 100% CDS FCSEMS ------Iwamuro et al [37] 7 100% 72% CDS 10 F PS Peritonitis 2 Occlusion 2 Eum et al [34] 3 100% 100% CDS 2 FCSEMS ------HGS 1 Artifon et al [38] 3 100% 100% CDS PCSEMS ------Artifon et al [39] 1 100% 100% CA PCSEMS ------Siddiqui et al [40] 8 100% 88% CDS FCSEMS Duodenal perforation 1 ---Fabbri et al [31] 16 75% (4 failure) 100% CDS 9 PCSEMS Pneumoperitoneum 1 ---RTPS 3 Table 1 Reports with self-expandable metallic stent placement SEMS: Self-expandable metallic stent.…”

“…In six reports [9,11,12,17,23,26] on EUS-guided rendezvous technique describing a total of 45 patients, the overall success rate was 80% (36/45). The complication rate was 4% (2/45), including pneumoperitoneum and bile leakage.…”

“…Several studies have evaluated the role of EUS-CDS [8,12,13,18,19,23,25,[27][28][29][30] . In these studies there are many differences in terms of type of devices used to create the fistula: needle knife or sphinterotome, 19 G or 22 G needles or needles followed by a needle knife.…”

“…Recently endoscopic ultrasonography-guided biliary drainage has been reported as an alternative technique by many researchers . Endoscopic ultrasonography-guided biliary drainage (EUS-BD) using either direct access or a rendezvous technique has attracted attention as an alternative procedure to PTBD, with a technical success between 75%-100% and with low complication rate [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] . Indeed another important advantage of EUS-BD compared with external PTBD is better quality of life due to the internal placement of the stent: this is undoubtedly a desirable goal; moreover, if allowed by local facilities, EUS-BD performed in the same session of the failed ERCP, in the same room and under the same sedation, could have many advantages for the patient and could be a rational approach also from the cost standpoint.…”

One-step Placement of a Fully-covered Metal Stent in Endosonography-guided Biliary Drainage for Malignant Biliary Obstruction

“…ESBD is performed via the gastrointestinal tract to the extra/intra-hepatic bile duct through the intra-abdominal space. Therefore, plastic stent placement via the puncture site to the target biliary duct is performed in the first session to prevent bile leakage in many reports (2)(3)(4)(5)(6)(7)(8)(9)(10)(11). Only a few case series undergoing ESBD with deployment of a covered self-expandable metal stent (SEMS) in a one-step fashion across the puncture site have been reported because there is a risk of migration of the deployed covered SEMS (5,7,8).…”