EUS-guided choledochoduodenostomy for malignant distal biliary obstruction using a lumen-apposing fully covered metal stent after failed ERCP

Kunda, Rastislav; Pérez-Miranda, Manuel; Will, Uwe; Ullrich, Sebastian; Brenke, Dirk; Dollhopf, Markus; Meier, Michelle; Larghi, Alberto

doi:10.1007/s00464-016-4845-6

Cited by 173 publications

(164 citation statements)

References 32 publications

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“…The reported 98% technical and over 96% clinical success rate, with only a 7% major complications compares favourably to previously published data using "conventional" FC-SEMS. 80 Similarly, a small randomised phase 1 trial of EUS-CDS with a novel 7 F stent introducer with tapered metal tip which acts as a dilator for one-step stent placement found the new system as efficacious as the "three step" process (puncture, tract dilation, and stent deployment), resulting in significant shortening of the duration of the procedure. 81 The stent used with the novel introducer system was a modified hybrid stent with an uncovered funnel-shaped proximal end and covered mid-body and a distal end; in addition, four anti-migratory flaps were placed in the distal end of the prosthesis to prevent spontaneous migration into the biliary system.…”

Section: Eus-cds and Eus-hgsmentioning

confidence: 99%

Endoscopic ultrasound-guided extraluminal drainage: Novel concepts, challenges and future directions

Madácsy

Kaltsidis²

2017

Int J Gastrointest Interv

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A B S T R A C TEndoscopic ultrasound (EUS)-guided management of abdominal fluid collections adjacent to the gastroduodenal lumen is a relatively new concept attracting a lot of interest in recent years. The ability of EUS to identify and drain these collections in the same session accounts for the surge of interest in these novel techniques. On the other hand, the complexity of these interventions and associated serious complications has moderated the enthusiasm of novice endoscopists to some extent and reiterated that focused research and technical innovations are needed to make EUS-guided drainage simpler and safer. Self-expandable metallic stents (SEMS) have emerged in the last decade in the endoscopic management of malignant luminal gastrointestinal strictures. The use of SEMS in the management of benign conditions (biliary, pancreatic, and colonic strictures) is also rapidly expanding. Recently, fully-covered (FC)-SEMS have been successfully used for drainage of peripancreatic and pericholecystic fluid collections. Here we will review the existing data and future directions in the use of FC-SEMS for such drainage procedures. We will also review the literature on novel "purpose-made" prostheses, such as the lumen-apposing metallic stents, which aim to address technical problems arising in EUS-guided drainage procedures when conventional SEMS are used. Further development of these and other similar devices may transform EUS-guided drainage procedures from an esoteric concept to "mainstream", first-line intervention.

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Section: Eus-cds and Eus-hgsmentioning

confidence: 99%

Endoscopic ultrasound-guided extraluminal drainage: Novel concepts, challenges and future directions

Madácsy

Kaltsidis²

2017

Int J Gastrointest Interv

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“…Although current data may be limited, EUS-guided biliary drainage is a safe alternative to surgery in patients with bile duct obstruction and a failed or impossible ERCP (3,7,9).…”

Section: Wiersema Et Al (8) Described For the First Time In 1996 Eusmentioning

confidence: 99%

“…However, this procedure cannot be performed in 5-10% of cases due to a failure in the cannulation of the bile duct or tumor infiltration (duodenal obstruction), which limits access to the bile duct. In these cases, alternative decompression methods are required (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic ultrasound-guided choledochoduodenostomy after a failed or impossible ERCP

Soler¹,

Delgado²,

Pérez

et al. 2018

Rev Esp Enferm Dig

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“…Either plastic or, preferably, self-expandable metal stents can be used, the last being fully or partially covered to minimize the risk of bile leakage. More recently, a novel electro-cautery lumen-opposing self-expanding metal stent (Hot AXIOS™ stent and delivery system) that is used to perform EUS-BD (choledocho-duodenal anastomosis) has been developed with the promise to allow faster and safer procedures [4] .…”

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasound-guided drainage of the biliary tree in malignant obstruction

Armellini¹,

Mazza²,

Ballarè³

et al. 2018

MIS

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Endoscopic retrograde cholangiopancreatography (ERCP) with stenosis stenting is the procedure of choice for treatment of malignant biliary obstruction. It has a low failure rate (< 5%-10% in cases of normal anatomy). The traditional alternative is radiological percutaneous drainage with a variable and non-negligible burden of adverse events. Interventional endoscopic ultrasound offers real-time imaging of the bilio-pancreatic district with the possibility of accessing the main biliary duct and the left hepatic duct from the duodenum or stomach. Consequently, endoscopic ultrasound-guided biliary drainage, including the rendezvous technique, choledochoduodenostomy, and/or hepaticogastro or antegrade stenting, has become a realistic option that offers advantages of a faster and cost-saving procedure since it can be performed immediately after ERCP, thus avoiding repeated sessions and prolonged hospital stays. We describe a case of malignant obstruction of the common bile duct that was drained by creation of choledocho-duodenal anastomosis under ultrasound-guided endoscopy.

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EUS-guided choledochoduodenostomy for malignant distal biliary obstruction using a lumen-apposing fully covered metal stent after failed ERCP

Abstract: Our study shows that EUS-CD using the AXIOS™ and the Hot AXIOS™ devices is a safe procedure, with high technical and clinical success rates.

Cited by 173 publications

References 32 publications

Endoscopic ultrasound-guided extraluminal drainage: Novel concepts, challenges and future directions

Endoscopic ultrasound-guided extraluminal drainage: Novel concepts, challenges and future directions

Endoscopic ultrasound-guided choledochoduodenostomy after a failed or impossible ERCP

Endoscopic ultrasound-guided drainage of the biliary tree in malignant obstruction

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