Relationship Between the Intraperitoneal Stent Length in Endoscopic Ultrasound-Guided Hepaticogastrostomy and Surgically Altered Upper Gastrointestinal Anatomy in Patients With Malignant Biliary Obstruction

Mandai, Koichiro; Uno, Koji; Yasuda, Kenjiro

doi:10.14740/gr1059w

Cited by 6 publications

(2 citation statements)

References 9 publications

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“…Long-term results were favorable and even at recurrence of biliary obstruction, treatment was achieved in most cases through the same previously placed stent. Another modification in the HGS method was proposed by Mandai et al, (31) to limit free space between the liver and the gastric wall. They used also a long partially covered metal stent but tried to keep pressing the gastric wall (the intraperitoneal stent length) with the scope tip until the stent was deployed more than 1 cm inside the scope's working channel.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound-guided biliary drainage for distal malignant biliary obstruction: a prospective 3-year multicenter Egyptian study

Ragab¹,

Abdel-Hameed²,

Gouda³

et al. 2023

AGEB

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Background/Aim: Malignant biliary obstruction (MBO) is often diagnosed at late stages with mostly unresectable lesions. Recently, EUS-guided biliary drainage (EUS-BD) has gained wide acceptance and appears to be a feasible and safe backup option after ERCP failure in such patients. Herein, we aimed to represent a 3-year multi-center Egyptian experience in the application of this challenging procedure for distal MBO as a salvage technique after failed ERCP. Patients and methods: This was a prospective multi-center study of patients underwent EUS-BD for distal MBO in the duration between December 2018 and December 2021, after ERCP failure. Results: Ninety-one patients (59 males, median age: 61 years) were included in the study. EUS-guided extrahepatic approach including choledocho-duodenostomy (CDS) was done for 48 patients (52.8%), followed by choledecho-antrostomy (CAS) in 4 patients (4.4%). The intrahepatic approach included hepaticogastrostomy (HGS) for 35 patients (38.5%) and antegrade stenting (AG) stenting in 2 patients (2.2%), while Rendezvous (RV) approach was performed in 2 patients (2.2%). Technical and Clinical success were achieved in the majority of cases; 93.4% and 94.1% respectively. Adverse events occurred in 13.2% of patients which were mostly mild (8.2%) to moderate (2.4%). Only one patient died within 48h after the procedure with progression of preceding sepsis and organ failure. Conclusion: EUS-BD is a feasible option, even in developing countries, after a failed ERCP, and it is a relatively safe option in patients with MBO once experienced team and resources were present. Majority of cases in our study have achieved technical and clinical success with relatively low incidence of adverse events

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Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound-guided biliary drainage for distal malignant biliary obstruction: a prospective 3-year multicenter Egyptian study

Ragab¹,

Abdel-Hameed²,

Gouda³

et al. 2023

AGEB

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“…The rate of adverse events of EUS-BD in patients with SAA seems to be roughly similar to that reported in patients with native GI anatomy. [51]…”

Section: Outcomes Of Eus-biliary Drainage In Patients With Surgicallymentioning

confidence: 99%

EUS-guided biliary drainage for postsurgical anatomy

et al. 2019

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ERCP is the mainstay of therapy for pancreatobiliary diseases in patients with native upper gastrointestinal (UGI) anatomy. However, when UGI anatomy is surgically altered, standard ERCP becomes technically challenging or not possible. In such instances, EUS-guided biliary drainage (EUS-BD) has been increasingly employed by advanced endoscopists as a safe and effective method of access to the biliary tree. In this study, we review the technical aspects and outcomes of EUS-BD in patients with surgical UGI anatomy.

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Equipment and Accessories for Therapeutic Endoscopic Ultrasound

Rimbaș

Larghi

2020

Therapeutic Endoscopic Ultrasound

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Relationship Between the Intraperitoneal Stent Length in Endoscopic Ultrasound-Guided Hepaticogastrostomy and Surgically Altered Upper Gastrointestinal Anatomy in Patients With Malignant Biliary Obstruction

Cited by 6 publications

References 9 publications

Endoscopic ultrasound-guided biliary drainage for distal malignant biliary obstruction: a prospective 3-year multicenter Egyptian study

Endoscopic ultrasound-guided biliary drainage for distal malignant biliary obstruction: a prospective 3-year multicenter Egyptian study

EUS-guided biliary drainage for postsurgical anatomy

Equipment and Accessories for Therapeutic Endoscopic Ultrasound

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