Is EUS-guided drainage a suitable alternative technique in case of proximal biliary obstruction?

Moryoussef, Frédérick; Sportes, Adrien; Leblanc, Sarah; Bachet, Jean‐Baptiste; Chaussade, Stanislas; Prat, Frédéric

doi:10.1177/1756283x17702614

Cited by 39 publications

(41 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A study done by Moryoussef et al . also showed results of EUS‐BD in patients with MHBO . Eighteen patients were included with 15 classifiable stenosis only: seven (47%) were noted as Bismuth I–II, seven (47%) as Bismuth III, and one (6.7%) as Bismuth IV.…”

Section: Results Of Previous Studies For Eus‐bd In Mhbomentioning

confidence: 99%

“…A study done by Moryoussef et al also showed results of EUS-BD in patients with MHBO. 8 Eighteen patients were included with 15 classifiable stenosis only: seven (47%) were noted as Bismuth I-II, seven (47%) as Bismuth III, and one (6.7%) as Bismuth IV. Reasons for EUS-BD were surgically modified anatomy in 10 patients (55.6%), impassable stricture at ERCP in seven (38.9%) and duodenal obstruction in one (5.6%).…”

Section: Results Of Previous Studies For Eus-bd In Mhbomentioning

confidence: 99%

See 1 more Smart Citation

Combination of endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography‐guided biliary drainage in malignant hilar biliary obstruction

Kongkam

Tasneem

Rerknimitr

2019

Digestive Endoscopy

View full text Add to dashboard Cite

Adequate biliary drainage (BD), defined as more than 50% of liver volume drained, is an ideal BD method in patients with advanced and unresectable malignant hilar biliary obstruction (MHBO). Endoscopic retrograde cholangiopancreatography (ERCP) with multi‐segmental BD is technically challenging. ERCP with percutaneous biliary drainage (PTBD) or PTBD alone has cumbersome maintenance of PTBD line and external bag. The utility of EUS‐guided BD (EUS‐BD) has risen significantly over last 5 years mostly in the clinical setting of distal bile duct obstruction. Information on EUS‐BD for malignant hilar biliary obstruction (MHBO) is thus far limited to only two small studies. This review suggests a new concept of a combination of ERCP and EUS‐BD (CERES) for BD in MHBO as a primary BD method whereby ERCP with a single self‐expandable metal stent (SEMS) is placed into either the right or the left intrahepatic bile duct (IHD). If SEMS is placed in the right biliary system, EUS‐guided hepaticogastrostomy (EUS‐HGS) can subsequently be carried out. However, if the stent is placed into the left biliary system, EUS‐guided hepaticoduodenostomy (EUS‐HDS) is done. For MHBO with non‐functioning right lobe of the liver, EUS‐HGS is carried out after failed ERCP, or primary HGS can be carried out in the left lobe of liver. For MHBO with non‐functioning left lobe of the liver, EUS‐HDS is carried out after failed transpapillary stenting of the right lobe by ERCP. Based on our experience, CERES is promising as it can fulfil gaps of both PTBD and ERCP by allowing internal drainage that can circumvent the inconvenience associated with PTBD and offer higher technical success rate compared to ERCP with bilateral SEMS placement.

show abstract

Section: Results Of Previous Studies For Eus‐bd In Mhbomentioning

confidence: 99%

Section: Results Of Previous Studies For Eus-bd In Mhbomentioning

confidence: 99%

Combination of endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography‐guided biliary drainage in malignant hilar biliary obstruction

Kongkam

Tasneem

Rerknimitr

2019

Digestive Endoscopy

View full text Add to dashboard Cite

show abstract

“…published a first case series with seven patients describing this bridge technique,[7] which was already described in an abstract by our team. [15] More recently, a French team described this kind of drainage being used in three patients[8] in a series of 18 patients with hilar strictures and failure of ERCP.…”

Section: Discussionmentioning

confidence: 99%

“…Moryoussef et al . [8] tried to answer the question regarding the technical success rate, finding a success rate of 50%, but with only three patients. Case description was limited because of this retrospective design, especially if the pejorative evolution of Type III (salvage PCT) and IV (death on day 7) is due to nondrainage of the opacified segments.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Drainage of the right liver under EUS guidance: A bridge technique allowing drainage of the right liver through the left liver into the stomach or jejunum

Caillol

Bosshardt

et al. 2019

Endosc Ultrasound

View full text Add to dashboard Cite

Background and Objective: EUS-guided biliary drainage is now comparable to percutaneous drainage. This technique can be used in cases of complex drainage of the hilum, mainly for salvage therapy to drain the left liver. In cases of inaccessible papilla or altered anatomy, EUS-guided biliary drainage for hilar stenosis of the liver could be used as the first approach. However, this technique has limited applicability for the right liver. In this feasibility study, we reported drainage of the right liver using the bridge technique and hepaticogastrostomy. Patients and Methods: This retrospective study was based on a prospective registry from January 2013 to February 2017. Patients with inaccessible papilla due to altered anatomy or duodenal invasion and drainage under EUS guidance and bridge technique without previous biliary drainage were included in the study. The bridge technique was used to place an uncovered biliary stent between the right and left liver. The left liver was drained with a hepaticogastrostomy. Results: Twelve patients were included in the study. Stenosis was Type II for nine, IIIA for two, and Type IV for one patient. Technical and clinical success was 100% and 83%, respectively. Morbidity was 33% (four patients), including three with abdominal pain managed conservatively and one with a percutaneous salvage drainage. Postoperative mortality was 8% (uncontrolled sepsis). The mean survival was 6 months. Chemotherapy could be administered in 70% (seven) patients in cases of clinical success. Conclusion: The bridge technique under EUS guidance could be a first alternative for draining malignant hilar stenosis in cases of the inaccessible papilla.

show abstract

Recent advances regarding endoscopic biliary drainage for unresectable malignant hilar biliary obstruction

Kato

Matsumoto

2021

DEN Open

View full text Add to dashboard Cite

Biliary drainage for unresectable malignant hilar biliary obstruction (UMHBO) is still associated with a number of controversies to be resolved. The superiority of bilateral drainage in comparison to unilateral drainage has not been proven obviously yet. However, bilateral drainage is necessary to treat obstructive jaundice in some UMHBO patients, and this may be connected with preservation of the functional liver volume. The partial stent‐in‐stent (SIS) method and side‐by‐side (SBS) method developed as bilateral drainage methods. There is no significant difference in the technical or clinical success rates of the SIS and SBS methods. In addition, these methods are comparable in terms of adverse events, patency period, and survival period. On the other hand, reintervention for recurrent biliary obstruction (RBO) after the SBS method seems to be easier in comparison to cases with RBO after the SIS method; however, there is no remarkable difference in the clinical results of these procedures. Endoscopic ultrasound (EUS)‐guided biliary drainage also has become an option for patients with UMHBO. Left hepatic drainage using EUS‐guided hepaticogastrostomy (EUS‐HGS) has become common; however, few studies have reported the results of bridging drainage for the right lobe using the EUS‐HGS route or EUS‐guided hepaticojejunostomy. A few studies addressed the results of newly designed stents, such as the 6‐mm braided metal stent and inside stent. The development of various drainage methods and new devices is necessary for the further advancement of endoscopic biliary drainage for patients with UMHBO, further studies to evaluate those methods and devices are warranted.

show abstract

Is EUS-guided drainage a suitable alternative technique in case of proximal biliary obstruction?

Cited by 39 publications

References 16 publications

Combination of endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography‐guided biliary drainage in malignant hilar biliary obstruction

Combination of endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography‐guided biliary drainage in malignant hilar biliary obstruction

Drainage of the right liver under EUS guidance: A bridge technique allowing drainage of the right liver through the left liver into the stomach or jejunum

Recent advances regarding endoscopic biliary drainage for unresectable malignant hilar biliary obstruction

Contact Info

Product

Resources

About