The diagnostic accuracy of endoscopic ultrasound in suspected biliary obstruction and its impact on endoscopic retrograde cholangiopancreatography burden in real clinical practice

2013 ◽  
Vol 25 (7) ◽  
pp. 850-857 ◽  
Author(s):  
Abdul Zaheer ◽  
Malik M. Anwar ◽  
Claire Donohoe ◽  
Sinead O’Keeffe ◽  
Hamid Mushtaq ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Diagnostic Accuracy ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Endoscopic Ultrasound ◽  
Biliary Obstruction ◽  
Endoscopic Retrograde ◽  
Real Clinical Practice

scholarly journals Relief of biliary obstruction: choosing between endoscopic ultrasound and endoscopic retrograde cholangiopancreatography

2020 ◽  
Vol 7 (1) ◽  
pp. e000428
Author(s):  
Andrew Canakis ◽  
Todd H Baron
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Endoscopic Ultrasound ◽  
Gold Standard ◽  
Biliary Obstruction ◽  
Diagnostic Technique ◽  
Endoscopic Retrograde ◽  
Surgically Altered Anatomy ◽  
Alternative Modality ◽  
Periampullary Diverticulum ◽  
Shed Light

Endoscopic ultrasound (EUS) was originally devised as a novel diagnostic technique to enable endoscopists to stage malignancies and acquire tissue. However, it rapidly advanced toward therapeutic applications and has provided gastroenterologists with the ability to effectively treat and manage advanced diseases in a minimally invasive manner. EUS-guided biliary drainage (EUS-BD) has gained considerable attention as an approach to provide relief in malignant and benign biliary obstruction for patients when endoscopic retrograde cholangiopancreatography (ERCP) fails or is not feasible. Such instances occur in those with surgically altered anatomy, gastroduodenal obstruction, periampullary diverticulum or prior transampullary duodenal stenting. While ERCP remains the gold standard, a multitude of studies are showing that EUS-BD can be used as an alternative modality even in patients who could successfully undergo ERCP. This review will shed light on recent EUS-guided advancements and techniques in malignant and benign biliary obstruction.

scholarly journals Endoscopic Ultrasound-Guided Biliary Drainage Using a Fully Covered Metallic Stent after Failed Endoscopic Retrograde Cholangiopancreatography

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Jintao Guo ◽  
Siyu Sun ◽  
Xiang Liu ◽  
Sheng Wang ◽  
Nan Ge ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Endoscopic Ultrasound ◽  
Biliary Drainage ◽  
Biliary Obstruction ◽  
Clinical Success ◽  
Metallic Stent ◽  
Endoscopic Retrograde ◽  
Primary Tumors ◽  
Covered Metallic Stent

Background and Study Aims.Endoscopic ultrasound- (EUS-) guided biliary drainage (EUS-BD) is an alternative treatment for biliary obstruction after failed endoscopic retrograde cholangiopancreatography (ERCP). In this study, we present the outcomes of inpatients with obstructive jaundice treated with EUS-BD using a fully covered metallic stent after failed ERCP.Patients and Methods.A total of 21 patients with biliary obstruction due to malignant tumors and prior unsuccessful ERCP underwent EUS via an intra- or extrahepatic approach with fully covered metallic stent between March 2014 and October 2015. A single endoscopist performed all procedures.Results.Seven patients underwent hepatogastrostomy (HGS) and 14 underwent choledochoduodenostomy (CDS). The technical and clinical success rates were both 100%. There was no difference in efficacy between HGS and CDS. Adverse events occurred in three patients, including two in the HGS group (1 bile leakage and 1 sepsis) and one in the CDS group (sepsis). Four patients died as a result of their primary tumors during a median follow-up period of 13 months (range: 3–21 months). No patient presented with stent migration.Conclusion.EUS-BD using a fully covered metallic stent appears to be a safe and effective method for the treatment of obstructive jaundice.

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