Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage: predictors of successful outcome in patients who fail endoscopic retrograde cholangiopancreatography

2016 ◽  
Vol 30 (12) ◽  
pp. 5500-5505 ◽  
Author(s):  
Reem Z. Sharaiha ◽  
Nikhil A. Kumta ◽  
Amit P. Desai ◽  
Ersilia M. DeFilippis ◽  
Moamen Gabr ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Endoscopic Ultrasound ◽  
Biliary Drainage ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Successful Outcome ◽  
Ultrasound Guided ◽  
Endoscopic Retrograde ◽  
Transhepatic Biliary Drainage

scholarly journals Endoscopic ultrasound-guided choledochoduodenostomy with a lumen-apposing metal stent through an uncovered metal duodenal stent

2018 ◽  
Vol 06 (12) ◽  
pp. E1395-E1397 ◽  
Author(s):  
Adrien Sportes ◽  
Gheoghe Airinei ◽  
Ralph Kamel ◽  
Jean Raynaud ◽  
Robert Benamouzig
Keyword(s):  
Endoscopic Ultrasound ◽  
Biliary Drainage ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Boston Scientific ◽  
Metal Stent ◽  
Ultrasound Guided ◽  
Endoscopic Retrograde ◽  
New Device ◽  
Duodenal Stent ◽  
Transhepatic Biliary Drainage

Abstract Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) in patients with a preexisting duodenal stent is particularly challenging and has a low success rate. Endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) has been increasingly used as an alternative to percutaneous transhepatic biliary drainage after failed ERCP. EUS-guided choledochoduodenostomy (EUS-CD) and EUS-guided hepaticogastrostomy (EUS-HGS) have been reported to have similar efficacity. Recently, a novel dedicated fully-covered lumen-apposing metal stent (LAMS) has been developed for EUS-CD (Hot AXIOS; Boston Scientific, Massachusetts, United States). It seems that this new device decreases the morbidity of EUS-CD. We present a case in which EUS-CD with LAMS through an uncovered metal duodenal stent was used successfully.

scholarly journals ERCP plus endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage for malignant hilar biliary obstruction: a multicenter observational open-label study

Endoscopy ◽  
2020 ◽  
Vol 53 (01) ◽  
pp. 55-62 ◽  
Author(s):  
Pradermchai Kongkam ◽  
Theerapat Orprayoon ◽  
Chaloemphon Boonmee ◽  
Passakorn Sodarat ◽  
Orathai Seabmuangsai ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Biliary Drainage ◽  
Biliary Obstruction ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Ultrasound Guided ◽  
Group A ◽  
Hilar Biliary Obstruction ◽  
Malignant Hilar Biliary Obstruction ◽  
Group B ◽  
Transhepatic Biliary Drainage

Abstract Background Endoscopic retrograde cholangiopancreatography (ERCP) may not provide complete biliary drainage in patients with Bismuth III/IV malignant hilar biliary obstruction (MHBO). Complete biliary drainage is accomplished by adding percutaneous transhepatic biliary drainage (PTBD). We prospectively compared recurrent biliary obstruction (RBO) rates between combined ERCP and endoscopic ultrasound-guided biliary drainage (EUS-BD) vs. bilateral PTBD. Methods Patients with MHBO undergoing endoscopic procedures (group A) were compared with those undergoing bilateral PTBD (group B). The primary outcome was the 3-month RBO rate. Results 36 patients were recruited into groups A (n = 19) and B (n = 17). Rates of technical and clinical success, and complications of group A vs. B were 84.2 % (16/19) vs. 100 % (17/17; P = 0.23), 78.9 % (15/19) vs. 76.5 % (13/17; P > 0.99), and 26.3 % (5/19) vs. 35.3 % (6/17; P = 0.56), respectively. Within 3 and 6 months, RBO rates of group A vs. group B were 26.7 % (4/15) vs. 88.2 % (15/17; P  = 0.001) and 22.2 % (2/9) vs. 100 % (9/9; P = 0.002), respectively. At 3 months, median number of biliary reinterventions in group A was significantly lower than in group B (0 [interquartile range] 0–1 vs. 1 [1–2.5]), respectively (P < 0.001). Median time to development of RBO was longer in group A than in group B (92 [56–217] vs. 40 [13.5–57.8] days, respectively; P  =  0.06). Conclusions Combined ERCP and EUS procedures provided significantly lower RBO rates at 3 and 6 months vs. bilateral PTBD, with similar complication rates and no significant mortality difference.

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