Endoscopic Palliation of Pancreaticobiliary Malignancies

Shah, Janak N.; Muthusamy, V. Raman

doi:10.1016/j.giec.2005.03.003

Cited by 12 publications

(4 citation statements)

References 103 publications

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“…Malignant biliary obstruction is most often caused by tumours that are not suitable for surgical resection, owing to their advanced stage at diagnosis [1,2]. Consequently, palliative relief of common bile duct obstruction is an important part of patient management to prevent jaundice and cholangitis [2].…”

Section: Introductionmentioning

confidence: 99%

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Do the benefits of metal stents justify the costs? A systematic review and meta-analysis of trials comparing endoscopic stents for malignant biliary obstruction

Moss

Morris

Leyden

et al. 2007

European Journal of Gastroenterology & Hepatology

178

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Section: Introductionmentioning

confidence: 99%

“…Consequently, palliative relief of common bile duct obstruction is an important part of patient management to prevent jaundice and cholangitis [2]. Endoscopic insertion of prosthesis in the biliary tree is the most common means of palliation of malignant common bile duct obstruction.…”

Section: Introductionmentioning

confidence: 99%

Do the benefits of metal stents justify the costs? A systematic review and meta-analysis of trials comparing endoscopic stents for malignant biliary obstruction

Moss

Morris

Leyden

et al. 2007

European Journal of Gastroenterology & Hepatology

178

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“…2 The current approach to relieve malignant biliary obstruction is either through percutaneous or endoscopic stenting. The latter approach is more popular because it is less invasive and more comfortable for the patients.…”

mentioning

confidence: 99%

Self-expandable metal stents versus plastic stents for malignant biliary obstruction: a meta-analysis

Sawas

Halabi

Parsi

et al. 2015

Gastrointestinal Endoscopy

214

163

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“…Endoscopic retrograde cholangiopancreatography (ERCP) with placement of self-expandable metal stents (SEMS) is the standard treatment for bile duct obstruction from advanced malignancy [1]. However, standard ERCP with retrograde stenting may not be possible in situations with an inaccessible biliary orifice, such as post-surgical altered anatomy or high-grade duodenal stenosis.…”

mentioning

confidence: 99%

Endoscopic ultrasound (EUS)-guided transhepatic anterograde self-expandable metal stent (SEMS) placement across malignant biliary obstruction

et al. 2010

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Endoscopic retrograde cholangiopancreatography (ERCP) with placement of self-expandable metal stents (SEMS) for palliation of malignant obstruction may not be possible in patients with an inaccessible biliary orifice. Endoscopic ultrasound (EUS)-guided drainage methods may be useful in this setting. This study aimed to determine the outcomes of EUS-guided anterograde SEMS placement across malignant strictures in patients with an inaccessible biliary orifice. Over a 2-year period, procedural and outcomes data on all patients undergoing EUS-guided anterograde SEMS drainage after failed ERCP were prospectively entered into a database and reviewed. Five patients underwent EUS-guided anterograde SEMS. Indications included: advanced pancreatic cancer (n = 3), metastatic cancer (n = 1), and anastomotic stricture (n = 1). The biliary orifice could not be reached endoscopically due to duodenal stricture (n = 4) or inaccessible hepaticojejunostomy (n = 1). EUS-guided punctures were performed transgastrically into left intrahepatic ducts (n = 4) or transbulbar into the common bile duct (n = 1). Guide wires were passed and SEMS were successfully deployed across strictures in an anterograde fashion in all patients. Jaundice resolved and serum bilirubin levels decreased in all cases. No procedure-related complications were noted during a mean follow-up of 9.2 months. EUS-guided anterograde SEMS placement appears to be a safe and efficient technique for palliation of biliary obstruction in patients with an endoscopically inaccessible biliary orifice. The procedure can be performed at the time of failed standard ERCP, and provides an alternative drainage option to percutaneous or surgical decompression and to EUS-guided creation of bilioenteric fistulae.

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Endoscopic Palliation of Pancreaticobiliary Malignancies

Cited by 12 publications

References 103 publications

Do the benefits of metal stents justify the costs? A systematic review and meta-analysis of trials comparing endoscopic stents for malignant biliary obstruction

Do the benefits of metal stents justify the costs? A systematic review and meta-analysis of trials comparing endoscopic stents for malignant biliary obstruction

Self-expandable metal stents versus plastic stents for malignant biliary obstruction: a meta-analysis

Endoscopic ultrasound (EUS)-guided transhepatic anterograde self-expandable metal stent (SEMS) placement across malignant biliary obstruction

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