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 Recent Advances of Interventional Endoscopic Retrograde Cholangiopancreatography and Endoscopic Ultrasound for Patients with Surgically Altered Anatomy

2021 ◽  
Vol 10 (8) ◽  
pp. 1624
Author(s):  
Yuki Tanisaka ◽  
Masafumi Mizuide ◽  
Akashi Fujita ◽  
Tomoya Ogawa ◽  
Masahiro Suzuki ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Endoscopic Ultrasound ◽  
Stone Extraction ◽  
Endoscopic Retrograde ◽  
Interventional Eus ◽  
Advantages And Disadvantages ◽  
Recent Advances ◽  
Choice Of Procedure ◽  
Surgically Altered Anatomy ◽  
Difficult Cases

Endoscopic retrograde cholangiopancreatography (ERCP) is considered to be the gold standard for diagnosis and interventions in biliopancreatic diseases. However, ERCP in patients with surgically altered anatomy (SAA) appears to be more difficult compared to cases with normal anatomy. Since the production of a balloon enteroscope (BE) for small intestine disorders, BE had also been used for biliopancreatic diseases in patients with SAA. Since the development of BE-assisted ERCP, the outcomes of procedures, such as stone extraction or drainage, have been reported as favorable. Recently, an interventional endoscopic ultrasound (EUS), such as EUS-guided biliary drainage (EUS-BD), has been developed and is available mainly for patients with difficult cases of ERCP. It is a good option for patients with SAA. The effectiveness of interventional EUS for patients with SAA has been reported. Both BE-assisted ERCP and interventional EUS have advantages and disadvantages. The choice of procedure should be individualized to the patient’s condition or the expertise of the endoscopists. The aim of this review article is to discuss recent advances in interventional ERCP and EUS for patients with SAA.

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.

Sign in / Sign up

Export Citation Format

Share Document