Endoscopic ultrasound and endoscopic retrograde cholangiopancreatography: Can they be successfully combined?

Gornals, Joan B.; Esteban, José M.; Guarner–Argente, Carlos; Marra-López, Carlos; Repiso, Alejandro; Sendino, Oriol; Alastruey, Carme Loras

doi:10.1016/j.gastre.2016.10.012

Cited by 5 publications

(12 citation statements)

References 112 publications

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“…In fact, in two extensive meta-analyses using ERCP or surgical exploration as criterion standards, EUS revealed a sensitivity of 89-94% and a specificity of 94-95% in the evaluation of choledocholithiasis [14,15]. It is estimated that EUS can be used in selecting patients for therapeutic ERCP, avoiding "diagnostic" ERCPs and their complications in 60-75% of cases [4,16].…”

Section: Choledocholithiasismentioning

confidence: 99%

“…In these patients, an EUS-ERCP sequential approach has clear advantages, the former with an important role in the 142 correct diagnosis (with the possibility of performing FNA) and staging of the tumor, and the latter being the technique of choice when biliary drainage is indicated. In these cases, the information provided by EUS in relation to tumor stage may contribute to the choice of drainage modality, namely the option of a plastic or metallic stent [4].…”

Section: Diagnosis Of Pancreatobiliary Neoplasiasmentioning

confidence: 99%

“…Addition of endobiliary forceps biopsy improves sensitivity, but it is time consuming, increases costs, and may not be technically feasible [27]. Nevertheless, when strictures are not associated with a mass-forming lesion, ERCP cytology with or without forceps biopsy seems to be superior to EUS-FNA [4]. Another chance for interventional EUS to come close to ERCP is the exponentially growing indications for interventional EUS in biliopancreatic drainage procedures.…”

Section: Diagnosis Of Pancreatobiliary Neoplasiasmentioning

confidence: 99%

“…[4,28]. In this context, EUS is assumed as a first-line rescue option, with advantages in relation to surgery or percutaneous drainage.…”

Section: Diagnosis Of Pancreatobiliary Neoplasiasmentioning

confidence: 99%

“…These intervention techniques include drainage procedures of biliary and pancreatic ducts, peridigestive collections, interluminal anastomoses and, more recently, antitumor therapies and vascular interventions [3]. Much of this long and auspicious way was simplified by the fact that EUS procedures share numerous devices and accessories used and developed for ERCP [4].…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic Retrograde Cholangiopancreatography and Endoscopic Ultrasound: To Be One Traveler in Converging Roads

Moutinho-Ribeiro

Peixoto

Macedo³

2017

GE Port J Gastroenterol

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Background: Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) were initially introduced into the world of gastroenterology as purely diagnostic procedures. With progressive evolution of intervention, both these techniques conquered fields in the treatment of many conditions that had once been exclusively surgical domains. Nowadays, more and more clinical situations have an indication to perform both EUS and ERCP, and these two techniques are frequently required at the same time for the same patient. More than competitors, ERCP and EUS are truly complementary, with great ability for mutual aid. They share their main indications, equipment, accessories, and main technical gestures. Objectives and Methods: We review the major indications to perform both techniques, sequentially or complementarily, describe the common things that these two techniques essentially share, and discuss the ERCP-EUS single session. Also, the issues of learning curves and education of upcoming biliopancreatic endoscopists are highlighted. Conclusion: In recent years the complementation between ECRP and EUS has been growing both from a diagnostic and a therapeutic point of view, allowing optimization of the use of these techniques and the creation of a more systematized approach of patients with biliopancreatic pathology. Endoscopists with experience in both techniques will be increasingly important, suggesting a parallel formation in the training plans of future endoscopists with interest in the area.

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Section: Choledocholithiasismentioning

confidence: 99%

Section: Diagnosis Of Pancreatobiliary Neoplasiasmentioning

confidence: 99%

Section: Diagnosis Of Pancreatobiliary Neoplasiasmentioning

confidence: 99%

“…[4,28]. In this context, EUS is assumed as a first-line rescue option, with advantages in relation to surgery or percutaneous drainage.…”

Section: Diagnosis Of Pancreatobiliary Neoplasiasmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Endoscopic Retrograde Cholangiopancreatography and Endoscopic Ultrasound: To Be One Traveler in Converging Roads

Moutinho-Ribeiro

Peixoto

Macedo³

2017

GE Port J Gastroenterol

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Endoscopic ultrasound‐guided hepaticogastrostomy using a partially covered metal stent in patients with malignant biliary obstruction after failed Endoscopic retrograde cholangiopancreatography

2020

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Background and Aim The advent of endoscopic ultrasound‐guided biliary drainage (EUS‐BD) has provided an inimitable alternative for gaining biliary access in patients who fail conventional endoscopic drainage. The antimigratory features of the partially covered metal stent (PCMS), namely, the flange head and uncovered portion of the stent, makes it a valuable option in patients undergoing EUS‐guided hepaticogastrostomy (EUS‐HGS). The aim of the study is to evaluate the clinical outcome of EUS‐BD via the hepaticogastrostomy approach using PCMS in patients with malignant biliary obstruction after failed ERCP. Methods This is a single‐center retrospective observational study of patients with malignant biliary obstruction undergoing EUS‐HGS after failed ERCP between January 2018 and May 2019. The end‐point of the study was to assess the technical and clinical success rate, as well as the stent‐ and procedure‐related complications. Results There were 20 subjects in this study. The average age was 71.8 ± 7.6 years. Most patients were male, 16 (80%). Inaccessible papillae was the most common indication for this procedure, 16 (80%). Technical success was achieved in all patients. The average procedural time was 39.9 ± 1.3 min. Mean preprocedural bilirubin levels were 348.6 ± 28.8 and subsequently decreased to 108.94 ± 37.1 μmol/L at 2 weeks postprocedure. The clinical success rate was 95% (19/20), with one patient requiring percutaneous transhepatic biliary drainage (PTBD). There were no stent‐ or procedure‐related complications reported in this study. Conclusion EUS‐HGS with PCMS is a feasible, effective, and safe alternative for biliary decompression in patients with failed endoscopic retrograde cholangiopancreatography (ERCP).

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Study of the standard direct costs of various techniques of advanced endoscopy. Comparison with surgical alternatives

Loras

Mayor

Fernández‐Bañares

2018

Digestive and Liver Disease

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Endoscopic ultrasound and endoscopic retrograde cholangiopancreatography: Can they be successfully combined?

Cited by 5 publications

References 112 publications

Endoscopic Retrograde Cholangiopancreatography and Endoscopic Ultrasound: To Be One Traveler in Converging Roads

Endoscopic Retrograde Cholangiopancreatography and Endoscopic Ultrasound: To Be One Traveler in Converging Roads

Endoscopic ultrasound‐guided hepaticogastrostomy using a partially covered metal stent in patients with malignant biliary obstruction after failed Endoscopic retrograde cholangiopancreatography

Study of the standard direct costs of various techniques of advanced endoscopy. Comparison with surgical alternatives

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