EUS-guided gallbladder drainage with a lumen-apposing metal stent (with video)

Irani, Shayan; Baron, Todd H.; Grimm, Ian S.; Khashab, Mouen A.

doi:10.1016/j.gie.2015.05.045

Cited by 113 publications

(89 citation statements)

References 21 publications

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“…Also, patients are left with a long-term external drain which remains with the patients till the end of life, thereby, leading to poor quality of life 19. EGBD has emerged as a noble option that is feasible, extremely safe, efficacious and minimally invasive 29–34. This procedure involves accessing the biliary tree from within the lumen of the gastrointestinal system using echoendoscopy and fluoroscopy, creating a fistulous tract and deploying a stent in a single-step procedure, thus, obviating the need for external drain 22,35.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage after failed endoscopic retrograde cholangiopancreatography: a meta-analysis

Baniya¹,

Upadhaya²,

Madala³

et al. 2017

CEG

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The failure rate of endoscopic retrograde cholangiopancreatography for biliary cannulation is approximately 6%–7% in cases of obstructive jaundice. Percutaneous transhepatic biliary drainage (PTBD) is the procedure of choice in such cases. Endoscopic ultrasound-guided biliary drainage (EGBD) is a novel technique that allows biliary drainage by echoendoscopy and fluoroscopy using a stent from the biliary tree to the gastrointestinal tract. Information in PubMed, Scopus, clinicaltrials.gov and Cochrane review were analyzed to obtain studies comparing EGBD and PTBD. Six studies fulfilled the inclusion criteria. Technical (odds ratio (OR): 0.34; confidence interval (CI) 0.10–1.14; p=0.05) and clinical (OR: 1.48; CI 0.46–4.79; p=0.51) success rates were not statistically significant between the EGBD and PTBD groups. Mild adverse events were nonsignificantly different (OR: 0.36; CI 0.10–1.24; p=0.11) but not the moderate-to-severe adverse events (OR: 0.16; CI 0.08–0.32; p≤0.00001) and total adverse events (OR: 0.34; CI 0.20–0.59; p≤0.0001). EGBD is equally effective but safer than PTBD.

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Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage after failed endoscopic retrograde cholangiopancreatography: a meta-analysis

Baniya¹,

Upadhaya²,

Madala³

et al. 2017

CEG

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“…Although the technical and clinical success rates and rate of adverse events were not significantly different between the two groups in their study, the reintervention rate was significantly higher in the PTGBD group compared with the EUS‐GBD group (28% vs 10%, P < 0.001). In addition, post‐procedure pain scores were significantly lower following EUS‐GBD . Therefore, because PTGBD may decrease the patient's quality of life as a result of external drainage, lead to prolonged hospital stay, frequent need for reintervention, and a tendency towards a higher incidence of adverse events compared with EUS‐GBD, EUS‐GBD may be preferable, especially for patients who are less likely to undergo future surgical treatment.…”

Section: Endoscopic Ultrasound‐guided‐gbd Versus Ptgbdmentioning

confidence: 99%

“…Recently, endoscopic ultrasound (EUS)‐guided transluminal drainage techniques have been developed for managing a variety of conditions, such as hepaticogastrostomy (HGS), pseudocyst drainage, pancreaticogastrostomy, and choledochoduodenostomy (CDS) . More recently, EUS‐guided gallbladder drainage (EUS‐GBD) is increasingly being carried out as an alternative method to PTGBD and ETGBD …”

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasound‐guided gallbladder drainage: Current status and future prospects

Ogura

Higuchi

2019

Digestive Endoscopy

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Early surgical treatment using the laparoscopic approach is generally accepted as the treatment of choice for acute cholecystitis (AC) according to Tokyo Guidelines 2018 (TG2018). If the patient is a poor candidate for surgery because of the presence of advanced malignancy or severe organ failure, this treatment may be too invasive. In such cases, gallbladder drainage is considered an alternative treatment method to surgery. Several drainage methods have been established, such as percutaneous transhepatic gallbladder drainage (PTGBD) or endoscopic transpapillary gallbladder drainage (ETGBD) under endoscopic retrograde cholangiopancreatography (ERCP), including endoscopic naso‐gallbladder drainage (ENGBD) and endoscopic gallbladder stenting (EGBS). PTGBD is a well‐established procedure that is relatively easily carried out by general clinicians. And ETGBD has been developed as an alternative drainage method. The procedure also calls for guidewire passage across the cystic duct. Therefore, in AC cases who are contraindicated for surgery, PTGBD should be considered before ETGBD, and ETGBD may be considered only in high‐volume institutes where expert hands are available, as described in the TG2018. However, there are several limitations to these procedures. Recently, endoscopic ultrasound‐guided gallbladder drainage (EUS‐GBD) is increasingly being done as an alternative method to PTGBD and ETGBD. In this review, the current status and problems of EUS‐GBD are reviewed, including technical review and clinical data of previous papers, current indication, long‐term outcome, and comparison data with PTGBD or ETGBD, and their future prospects are discussed.

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“…In a retrospective review of 15 non-surgical patients at 3 tertiary care centers who underwent EUS-GBD using the AXIOS LAMS to decompress the gallbladder, Irani et al 33 had technical success in 14/15 patients (93.3%) and achieved clinical success in 15/15 patients at a median follow-up of 160 days. They used a 10 × 10 mm stent in 12 patients and a 15 × 10 mm stent in 3 patients.…”

Section: Eus-guided Gallbladder Drainagementioning

confidence: 99%

Lumen apposing metal stents: A review of current uses and outcomes

Bank

Adler

2017

Int J Gastrointest Interv

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A B S T R A C TLumen-apposing metal stents (LAMS) represent a new innovation in gastrointestinal endoscopy. These devices have a saddle-shaped design and larger inner lumen diameter than either plastic or metal biliary stents, which should decrease the risk of migration and allows for an endoscope to pass into pancreatic fluid collections as well as the ability to perform direct endoscopic necrosectomy. LAMS were originally conceived and designed for transmural pancreatic fluid collection drainage but are currently also being used for many off label indications. There are three different LAMS available at this time around the globe. This manuscript will review the current state of the art with regards to LAMS and their indications, usage, and outcomes.

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EUS-guided gallbladder drainage with a lumen-apposing metal stent (with video)

Cited by 113 publications

References 21 publications

Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage after failed endoscopic retrograde cholangiopancreatography: a meta-analysis

Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage after failed endoscopic retrograde cholangiopancreatography: a meta-analysis

Endoscopic ultrasound‐guided gallbladder drainage: Current status and future prospects

Lumen apposing metal stents: A review of current uses and outcomes

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