EUS-guided biliary drainage: A systematic review and meta-analysis

Dhindsa, Banreet; Mashiana, Harmeet S.; Dhaliwal, Amaninder; Mohan, Babu P.; Jayaraj, Mahendran; Sayles, Harlan; Singh, Shailender; Ohning, Gordon V.; Bhat, Ishfaq; Adler, Douglas G.

doi:10.4103/eus.eus_80_19

Cited by 68 publications

(35 citation statements)

References 34 publications

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“…[ 34 ] In a more recent systematic review and meta-analysis including 1437 patients from 23 studies, a pooled rate of technical and clinical success of 91% (95% confidence interval [CI]: 87.7–94.2, I 2 = 76.5) and 87% (95% CI: 82.3–90.6, I 2 = 72.4), respectively, are shown. [ 35 ] The calculated pooled rate of re-intervention and adverse events were 6.5 (95% CI: 3.8–10.8, I 2 = 69.3) and 17.9% (95% CI: 14.3–22.2, I 2 = 69.1), respectively.…”

Section: Eus and Endoscopic Retrograde Cholangiopancreatography Collamentioning

confidence: 99%

EUS and ERCP: A rationale categorization of a productive partnership

2021

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ERCP and EUS are complementary techniques in the management of biliary and pancreatic diseases. Combination of these two techniques can reach different levels of complexity with increasing rates of adverse events. In this article we propose a categorization of the relationship between EUS and ERCP based on whether EUS indicates, complements, facilitates or replaces ERCP. It has implications for the complexity of the technique, the training of the endoscopist and the necessary hospital resources. This classification can also be useful in planning endoscopist training and patient management.

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Section: Eus and Endoscopic Retrograde Cholangiopancreatography Collamentioning

confidence: 99%

EUS and ERCP: A rationale categorization of a productive partnership

2021

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“…Adverse events occurred in 17.9%. The main adverse events were bile leakage (4.1%), stent migration (3.9%), and infections (3.8%) [ 65 ]. Although there were high success rates using interventional EUS, adverse events were higher than BE-assisted ERCP.…”

Section: Interventional Eusmentioning

confidence: 99%

Recent Advances of Interventional Endoscopic Retrograde Cholangiopancreatography and Endoscopic Ultrasound for Patients with Surgically Altered Anatomy

Tanisaka

Mizuide

Fujita

et al. 2021

JCM

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Endoscopic retrograde cholangiopancreatography (ERCP) is considered to be the gold standard for diagnosis and interventions in biliopancreatic diseases. However, ERCP in patients with surgically altered anatomy (SAA) appears to be more difficult compared to cases with normal anatomy. Since the production of a balloon enteroscope (BE) for small intestine disorders, BE had also been used for biliopancreatic diseases in patients with SAA. Since the development of BE-assisted ERCP, the outcomes of procedures, such as stone extraction or drainage, have been reported as favorable. Recently, an interventional endoscopic ultrasound (EUS), such as EUS-guided biliary drainage (EUS-BD), has been developed and is available mainly for patients with difficult cases of ERCP. It is a good option for patients with SAA. The effectiveness of interventional EUS for patients with SAA has been reported. Both BE-assisted ERCP and interventional EUS have advantages and disadvantages. The choice of procedure should be individualized to the patient’s condition or the expertise of the endoscopists. The aim of this review article is to discuss recent advances in interventional ERCP and EUS for patients with SAA.

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“…A recent meta-analysis of twenty-three studies including 1437 patients found a technical success rate of 92% and a clinical success rate of 87% of EUS-BD using mixed approaches in a variety of indications [ 13 ]. Pooled AE rate was reported with 17.9%.…”

Section: Clinical Application and Performance Of Eus In Biliary DImentioning

confidence: 99%

“…Since then, EUS-BD has become an alternative to ERCP in cases that require BD [ 11 , 12 ] and in particular as a backup method if standard ERCP-approach fails. Various studies have reported high technical success rates associated with EUS-BD [ 11 , 12 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Management of Bile Duct Diseases: Role of Endoscopic Ultrasound in a Personalized Approach

Beyna

Gerges

2020

JPM

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Biliary diseases are common, but clinical symptoms are often unspecific and direct access and visualization of the biliopancreatic system for diagnostic purpose is difficult. In the last decades endoscopic ultrasound (EUS) has become a primary method in the gastrointestinal tract. It significantly changed the role of endoscopy in diagnostic imaging in the gastrointestinal tract and adjacent organs. EUS has become an effective diagnostic tool in biliary stone disease as well as in the diagnosis of indeterminate biliary strictures. Furthermore, an EUS-directed transmural approach emerged as a safe and effective alternative to ERCP in patients requiring biliary drainage, in particular as a backup method if standard ERCP-approach fails. Development of new techniques, specific accessories and stents during the last decade led to an enormous step forward in terms of efficacy and safety of an EUS-directed approach. In the current article technical and clinical aspects of EUS-guided diagnostic and therapeutic approaches in different clinical indications will be discussed together with a review of the available data.

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EUS-guided biliary drainage: A systematic review and meta-analysis

Cited by 68 publications

References 34 publications

EUS and ERCP: A rationale categorization of a productive partnership

EUS and ERCP: A rationale categorization of a productive partnership

Recent Advances of Interventional Endoscopic Retrograde Cholangiopancreatography and Endoscopic Ultrasound for Patients with Surgically Altered Anatomy

Clinical Management of Bile Duct Diseases: Role of Endoscopic Ultrasound in a Personalized Approach

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