EUS-guided rendezvous for difficult biliary cannulation using a standardized algorithm: a multicenter prospective pilot study (with videos)

Iwashita, Takuji; Yasuda, Ichiro; Mukai, Tsuyoshi; Iwata, Koichi; Ando, Nobuhiro; Doi, Shinpei; Nakashima, Masanori; Uemura, Shiro; Mabuchi, Masatoshi; Shimizu, Masahito

doi:10.1016/j.gie.2015.04.043

Cited by 88 publications

(85 citation statements)

References 21 publications

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“…The success rate of the intrahepatic bile duct approach is 76%, which is lower than that of the extrahepatic bile duct approach (85%). Prior studies involved patients with not only malignant biliary obstruction but also those with bile duct stones, and the lower success rate was due to guidewire manipulation to pass the biliary stricture or ampulla . In studies of EUS‐AGS , the success rate was 83%, similar to that of EUS‐RV, but conversion to transmural biliary drainage was reported in cases in which the guidewire could not be manipulated across the biliary stricture .…”

Section: Questions and Clinical Questions Of The Guidelinesmentioning

confidence: 99%

“…A pooled analysis of early adverse events among studies involving ≥20 cases yielded an incidence of early adverse events of 14.6% (100/755 cases) . The summary below includes all adverse events reported in each study (Table ).…”

Section: Questions and Clinical Questions Of The Guidelinesmentioning

confidence: 99%

“…The incidence of early adverse events of EUS-RV, including acute pancreatitis (2.7%), pneumoperitoneum (2.2%), bile peritonitis (1.4%), and hemorrhage (0.5%), is 12.4% (45/364 cases) [12,14,15,17,48,51,[72][73][74][75][76][77]. Other adverse events include perforation, hemorrhage (3.7%), bile leakage (2.8%), biloma (2.6%), stent migration (1.6%), stent misplacement (intrahepatic, intraperitoneal) (1.2%), intrahepatic hematoma (1.2%), and sepsis (1.2%).…”

Section: Q6 What Are the Adverse Events Of Eus-bd?mentioning

confidence: 99%

See 2 more Smart Citations

Clinical practice guidelines for safe performance of endoscopic ultrasound/ultrasonography‐guided biliary drainage: 2018

Isayama

Nakai

Itoi

et al. 2019

J Hepato Biliary Pancreat

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112

127

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Endoscopic ultrasound/ultrasonography‐guided biliary drainage (EUS‐BD) is a relatively new modality for biliary drainage after failed or difficult transpapillary biliary cannulation. Despite its clinical utility, EUS‐BD can be complicated by severe adverse events such as bleeding, perforation, and peritonitis. The aim of this paper is to provide practice guidelines for safe performance of EUS‐BD as well as safe introduction of the procedure to non‐expert centers. The guidelines comprised patient–intervention–comparison–outcome‐formatted clinical questions (CQs) and questions (Qs), which are background statements to facilitate understanding of the CQs. A literature search was performed using the PubMed and Cochrane Library databases. Statement, evidence level, and strength of recommendation were created according to the GRADE system. Four committees were organized: guideline creation, expert panelist, evaluation, and external evaluation committees. We developed 13 CQs (methods, device selection, supportive treatment, management of adverse events, education and ethics) and six Qs (definition, indication, outcomes and adverse events) with statements, evidence levels, and strengths of recommendation. The guidelines explain the technical aspects, management of adverse events, and ethics of EUS‐BD and its introduction to non‐expert institutions.

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Section: Questions and Clinical Questions Of The Guidelinesmentioning

confidence: 99%

Section: Questions and Clinical Questions Of The Guidelinesmentioning

confidence: 99%

Section: Q6 What Are the Adverse Events Of Eus-bd?mentioning

confidence: 99%

See 1 more Smart Citation

Clinical practice guidelines for safe performance of endoscopic ultrasound/ultrasonography‐guided biliary drainage: 2018

Isayama

Nakai

Itoi

et al. 2019

J Hepato Biliary Pancreat

Self Cite

112

127

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show abstract

“…EUS-RV is indicated in patients who fail ERCP but have endoscopic access to the ampulla or anastomosis site. 44,45 Transpapillary biliary cannulation. Therefore, this procedure is particularly indicated for patients with resectable malignant biliary obstruction or benign biliary disorders (e.g.…”

Section: Eus-guided Rendezvous Techniquementioning

confidence: 99%

Recent advances in endoscopic ultrasound‐guided biliary drainage

Minaga

Kitano

2017

Digestive Endoscopy

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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.

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“…For biliary drainage, there are two types of procedure: transmural drainage and transpapillary stenting using a guidewire introduced under EUS guidance. EUS‐guided hepaticogastrostomy (EUS‐HGS) or choledochoduodenostomy (EUS‐CDS) are the major procedures of transmural biliary drainage and EUS‐RV and antegrade stenting are the two EUS‐assisted transpapillary stenting procedures …”

Section: Eus‐guided Biliary Drainage and Gastrojejunostomymentioning

confidence: 99%

Endoscopic management of combined malignant biliary and gastric outlet obstruction

Nakai

Hamada

Isayama

et al. 2016

Digestive Endoscopy

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Patients with periampullary cancer or gastric cancer often develop malignant biliary obstruction (MBO) and gastric outlet obstruction (GOO), and combined MBO and GOO is not rare in these patients. Combined MBO and GOO is classified by its location and sequence, and treatment strategy can be affected by this classification. Historically, palliative surgery, hepaticojejunostomy and gastrojejunostomy were carried out, but the current standard treatment is combined transpapillary stent and duodenal stent placement. Although a high technical success rate is reported, the procedure can be technically difficult and duodenobiliary reflux with subsequent cholangitis is common after double stenting. Recent development of endoscopic ultrasound (EUS)-guided procedures enables the management of MBO as well as GOO under EUS guidance. EUS-guided biliary drainage is now increasingly reported as an alternative to percutaneous transhepatic biliary drainage in failed endoscopic retrograde cholangiopancreatography (ERCP), and GOO is one of the major reasons for failed ERCP. In addition to EUS-guided biliary drainage, the feasibility of EUS-guided double-balloon-occluded gastrojejunostomy bypass for MBO was recently reported, and EUS-guided double stenting can potentially become the treatment of choice in the future. However, as each procedure has its advantages and disadvantages, treatment strategy should be selected based on the type of obstruction and the prognosis and performance status of the patient.

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EUS-guided rendezvous for difficult biliary cannulation using a standardized algorithm: a multicenter prospective pilot study (with videos)

Cited by 88 publications

References 21 publications

Clinical practice guidelines for safe performance of endoscopic ultrasound/ultrasonography‐guided biliary drainage: 2018

Clinical practice guidelines for safe performance of endoscopic ultrasound/ultrasonography‐guided biliary drainage: 2018

Recent advances in endoscopic ultrasound‐guided biliary drainage

Endoscopic management of combined malignant biliary and gastric outlet obstruction

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