Consensus guidelines on the optimal management in interventional EUS procedures: results from the Asian EUS group RAND/UCLA expert panel

Teoh, Anthony Y.; Dhir, Vinay; Kida, Mitsuhiro; Yasuda, Ichiro; Jin, Zhen; Seo, Dong Wan; Almadi, Majid A; Ang, Tiing Leong; Hara, Kazuo; Hilmi, Ida; Itoi, Takao; Lakhtakia, Sundeep; Matsuda, Koji; Pausawasdi, Nonthalee; Puri, Rajesh; Tang, Raymond; Wang, Hsiu-Po; Yang, Ai Ming; Hawes, Robert H.; Varadarajulu, Shyam; Yasuda, Kenjiro; Ho, Lawrence K.Y.

doi:10.1136/gutjnl-2017-314341

Cited by 169 publications

(185 citation statements)

References 168 publications

(47 reference statements)

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“…This was a prospective international multicentered cohort study conducted in six high‐volume institutions across Asia. Consecutive patients suffering from symptomatic pancreatic pseudocyst or walled‐off necrosis (WOPN) persisting for more than 4 weeks and ≥6 cm in size were recruited . Patients that received prior surgical, endoscopic or percutaneous drainages were excluded.…”

Section: Methodsmentioning

confidence: 99%

Prospective multicenter international study on the outcomes of a newly developed self‐approximating lumen‐apposing metallic stent for drainage of pancreatic fluid collections and endoscopic necrosectomy

Teoh

Bapaye

Lakhtakia

et al. 2019

Digestive Endoscopy

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Background A novel self‐approximating lumen‐apposing metallic stent (LAMS; Niti‐S Spaxus, Taewoong Medical, Gyeonggi‐do, Korea) has recently become available. The aim of the present study was to evaluate the outcomes for drainage of pancreatic fluid collections (PFC). Methods This was a prospective international multicentered study conducted in six high‐volume institutions across Asia. Consecutive patients suffering from pancreatic pseudocyst or walled‐off pancreatic necrosis (WOPN) requiring endoscopic ultrasonography‐guided drainage were recruited. Outcomes included technical and clinical success, adverse events, procedural events, interventions through the stent and recurrence rates. Results Between August 2016 and November 2017, 59 patients were recruited to this study. Thirty‐nine patients (66.1%) had WOPN and mean (SD) size of PFC was 11.5 (5.1) cm. Technical and clinical success rates were 100%. Mean (SD) procedural time was 35.0 (17.2) minutes. Sixteen‐millimeter stents were used in 66.1% of the patients. Fifty‐four sessions of necrosectomy were carried out with the stent in situ in 17 patients. Stent‐related adverse event (AE) rate was 6.8%. Three patients (5.1%) suffered from bleeding after stenting and one required angiographic embolization. Two patients (3.4%) suffered from recurrence during a mean (SD) follow‐up time of 325.6 (355.5) days. There were no differences in outcomes between those with pseudocysts or WOPN except for the duration of hospital stay (P = 0.012). Conclusion Use of a self‐approximating LAMS for drainage of PFC was safe and effective. Endoscopic necrosectomy could be carried out through the stent with ease. The device was associated with a low rate of stent‐related AE.

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Section: Methodsmentioning

confidence: 99%

Prospective multicenter international study on the outcomes of a newly developed self‐approximating lumen‐apposing metallic stent for drainage of pancreatic fluid collections and endoscopic necrosectomy

Teoh

Bapaye

Lakhtakia

et al. 2019

Digestive Endoscopy

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“…1,2 Since its first report in 2001, 3 endoscopic ultrasound-guided biliary drainage (EUS-BD) has emerged as a new biliary decompression procedure and has been increasingly used as an effective alternative for biliary obstruction patients with failed ERCP. 4,5 In the last decade, EUS-BD has been attracting considerable attention and various endoscopic techniques have been described for its implementation. [6][7][8] Among these, EUS-BD with transmural stenting can be carried out by two main access routes: choledochoduodenostomy (CDS) and hepaticogastrostomy (HGS).…”

Section: Introductionmentioning

confidence: 99%

Comparison of the efficacy and safety of endoscopic ultrasound‐guided choledochoduodenostomy and hepaticogastrostomy for malignant distal biliary obstruction: Multicenter, randomized, clinical trial

Minaga

Ogura

Shiomi

et al. 2019

Digestive Endoscopy

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Background and Aim Endoscopic ultrasound‐guided biliary drainage (EUS‐BD) can be carried out by two different approaches: choledochoduodenostomy (CDS) and hepaticogastrostomy (HGS). We compared the efficacy and safety of these approaches in malignant distal biliary obstruction (MDBO) patients using a prospective, randomized clinical trial. Methods Patients with malignant distal biliary obstruction after failed endoscopic retrograde cholangiopancreatography were randomly selected for either CDS or HGS. The procedures were carried out at nine tertiary centers from September 2013 to March 2016. Primary endpoint was technical success rate, and the noninferiority of HGS to CDS was examined with a one‐sided significance level of 5%, where the noninferiority margin was set at 15%. Secondary endpoints were clinical success, adverse events (AE), stent patency, survival time, and overall technical success including alternative EUS‐BD procedures. Results Forty‐seven patients (HGS, 24; CDS, 23) were enrolled. Technical success rates were 87.5% and 82.6% in the HGS and CDS groups, respectively, where the lower limit of the 90% confidence interval of the risk difference was −12.2% (P = 0.0278). Clinical success rates were 100% and 94.7% in the HGS and CDS groups, respectively (P = 0.475). Overall AE rate, stent patency, and survival time did not differ between the groups. Overall technical success rates were 100% and 95.7% in the HGS and CDS groups, respectively (P = 0.983). Conclusions This study suggests that HGS is not inferior to CDS in terms of technical success. When one procedure is particularly challenging, readily switching to the other could increase technical success.

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“…Endoscopic ultrasonography‐guided pancreatic duct drainage can be indicated to patients with pancreatic duct obstruction, such as duodenal stenosis and surgically altered anatomy, after failed or unfavorable ERCP. This procedure can be achieved by the rendezvous method, pancreaticogastrostomy and antegrade drainage . However, this procedure has more technical hurdles than EUS‐BD and pancreatic cyst drainage.…”

Section: Eus‐guided Pancreatic Duct Drainagementioning

confidence: 99%

“…This procedure can be achieved by the rendezvous method, pancreaticogastrostomy and antegrade drainage. 7 However, this procedure has more technical hurdles than EUS-BD and pancreatic cyst drainage. The target (dilated pancreatic duct) is relatively small and often reached by passing through the hard fibrotic pancreatic parenchyma, which is difficult to puncture using standard needles.…”

Section: E Ndoscopic Ultrasonography-guidedmentioning

confidence: 99%

Current status and future perspectives of interventional endoscopic ultrasonography in Japan

Yasuda

Ryozawa

Dung

2019

Digestive Endoscopy

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Consensus guidelines on the optimal management in interventional EUS procedures: results from the Asian EUS group RAND/UCLA expert panel

Abstract: The current guidelines on interventional EUS procedures are the first published by an endoscopic society. These guidelines provide an in-depth review of the current evidence and standardise the management of the procedures.

Cited by 169 publications

References 168 publications

Prospective multicenter international study on the outcomes of a newly developed self‐approximating lumen‐apposing metallic stent for drainage of pancreatic fluid collections and endoscopic necrosectomy

Prospective multicenter international study on the outcomes of a newly developed self‐approximating lumen‐apposing metallic stent for drainage of pancreatic fluid collections and endoscopic necrosectomy

Comparison of the efficacy and safety of endoscopic ultrasound‐guided choledochoduodenostomy and hepaticogastrostomy for malignant distal biliary obstruction: Multicenter, randomized, clinical trial

Current status and future perspectives of interventional endoscopic ultrasonography in Japan

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