Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage: predictors of successful outcome in patients who fail endoscopic retrograde cholangiopancreatography

Sharaiha, Reem Z.; Kumta, Nikhil A.; Desai, Amit P.; DeFilippis, Ersilia M.; Gabr, Moamen; Sarkisian, Alex M.; Salgado, Sanjay; Millman, Jennifer E.; Benvenuto, Andrea; Cohen, Michelle; Tyberg, Amy; Gaidhane, Monica; Kahaleh, Michel

doi:10.1007/s00464-016-4913-y

Cited by 104 publications

(100 citation statements)

References 34 publications

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“…However, in recent years, the introduction of alternative, mainly endoscopic techniques for biliary drainage, like balloon-enteroscopy endoscopic retrograde cholangiography (ERC; in the case of Roux-Y anatomy) [1], endoscopic US-guided biliary drainage (EUS-BD) [2], or rendezvous techniques combining PTBD and ERC [3], have led to a decrease in the use of PTBD therapies. Especially EUS-BD has been proposed as the preferred alternative to PTBD with at least similar success and complication rates and an advantageous influence on the quality of life [4][5][6]. However, at present, PTBD still represents the therapeutic gold standard in cases of endoscopically (ERC) inaccessible bile ducts, particularly in the palliation of biliary malignancies [7].…”

Section: Comparison Of Ultrasound and Fluoroscopically Guided Percutamentioning

confidence: 99%

Comparison of Ultrasound and Fluoroscopically Guided Percutaneous Transhepatic Biliary Drainage

Nennstiel

Treiber

Faber

et al. 2018

Dig Dis

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Background: Percutaneous transhepatic biliary drainage (PTBD) plays a significant role especially in the palliation of an endoscopically inaccessible biliary system. Since a standard technique of PTBD is not defined, we compared a fluoroscopically guided technique (F-PTBD) with an ultrasound (US-PTBD) guided approach. Patients and Methods: Procedure characteristics, success-rates and complication-rates of the different PTBD techniques were compared in patients who underwent PTBD between October 1, 2006, and December 31, 2014. Results: In 195 patients, 251 PTBDs (207 F-PTBDs, 44 US-PTBDs) were performed. F-PTBDs were mostly inserted from the right and US-PTBDs from the left. Patient age, gender and physical status were comparable in both techniques. There was no difference regarding overall procedure success (90%/86.4%), overall interventional complication rates (10.6%/9.1%), fluoroscopy times, intervention times or sedatives dosages. However, major complications were only encountered in F-PTBDs. There was a higher success rate for F-PTBD vs. US-PTBD from the right side (91.9 vs. 75%; p = 0.033) and a trend towards a higher success rate for US guidance from the left side (82.9 vs. 95.8%; p = 0.223). Conclusions: For drainage of the right biliary system F-PTBD seems superior over the US-PTBD technique used in this study. However, major complications can occur more frequently in F-PTBD.

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Section: Comparison Of Ultrasound and Fluoroscopically Guided Percutamentioning

confidence: 99%

Comparison of Ultrasound and Fluoroscopically Guided Percutaneous Transhepatic Biliary Drainage

Nennstiel

Treiber

Faber

et al. 2018

Dig Dis

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“…The most common adverse events related to EUS-BD are bile leak which can occur in up to 3% of EUS patients, bleeding and cholangitis. 30 …”

Section: Of Either a Choledochoduodenostomy (Cd) (Eus-cd) Or A Hepatimentioning

confidence: 99%

Preoperative biliary drainage for pancreatic cancer

Ahmed

Lee

2018

Int J Gastrointest Interv

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Pancreatic cancer is a leading cause of cancer-related morbidity and mortality, but any meaningful improvement in its prognosis remains elusive. The lack of early diagnostic methods means that many patients only present when symptoms develop, such as obstructive jaundice. Once a diagnosis of pancreatic cancer has been made in a patient with obstructive jaundice, then a decision should be made if the patient is a candidate for surgical resection. Patients who are candidates for surgical resection generally do not need preoperative biliary drainage, unless they present with cholangitis, or if they require neo-adjuvant chemotherapy. If preoperative biliary drainage is to be done, then patient factors and local expertise should guide appropriate interventions. The evidence for endoscopic retrograde cholangiopancreatography as a first-line therapy for biliary decompression is strong; However, the use of percutaneous transhepatic biliary drainage as well as endoscopic ultrasound-guided biliary drainage has generally not been found to be inferior. Finally, to ensure ongoing patency and minimize complications, an appropriate self-expanding metal stent should ideally be placed.

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“…Percutaneous transhepatic biliary drainage (PTBD) has a more favorable adverse events profile than surgical decompression but is associated with complications like fistula formation, repeat intervention, recurrent infection, and needs a long-term external catheter drainage, thereby leading to poor quality of life 8–10. Endoscopic ultrasound-guided biliary drainage (EGBD) is a novel technique that allows visualization and access of biliary tree by echoendoscopy and fluoroscopy, which was first described by Giovannini et al11 It has the perceived benefits of being physiologic with anatomic internal drainage, improved comfort and recovery with less adverse events, and low cost 12. However, there are few studies published, to date, comparing the EGBD with PTBD in terms of success rate and adverse events profile in cases of failed ERCP 4,12–16.…”

Section: Introductionmentioning

confidence: 99%

“…Endoscopic ultrasound-guided biliary drainage (EGBD) is a novel technique that allows visualization and access of biliary tree by echoendoscopy and fluoroscopy, which was first described by Giovannini et al11 It has the perceived benefits of being physiologic with anatomic internal drainage, improved comfort and recovery with less adverse events, and low cost 12. However, there are few studies published, to date, comparing the EGBD with PTBD in terms of success rate and adverse events profile in cases of failed ERCP 4,12–16. Therefore, we conducted a meta-analysis to determine the aggregated efficacy and adverse events of EGBD and PTBD in such cases of failed ERCP.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage after failed endoscopic retrograde cholangiopancreatography: a meta-analysis

Baniya¹,

Upadhaya²,

Madala³

et al. 2017

CEG

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The failure rate of endoscopic retrograde cholangiopancreatography for biliary cannulation is approximately 6%–7% in cases of obstructive jaundice. Percutaneous transhepatic biliary drainage (PTBD) is the procedure of choice in such cases. Endoscopic ultrasound-guided biliary drainage (EGBD) is a novel technique that allows biliary drainage by echoendoscopy and fluoroscopy using a stent from the biliary tree to the gastrointestinal tract. Information in PubMed, Scopus, clinicaltrials.gov and Cochrane review were analyzed to obtain studies comparing EGBD and PTBD. Six studies fulfilled the inclusion criteria. Technical (odds ratio (OR): 0.34; confidence interval (CI) 0.10–1.14; p=0.05) and clinical (OR: 1.48; CI 0.46–4.79; p=0.51) success rates were not statistically significant between the EGBD and PTBD groups. Mild adverse events were nonsignificantly different (OR: 0.36; CI 0.10–1.24; p=0.11) but not the moderate-to-severe adverse events (OR: 0.16; CI 0.08–0.32; p≤0.00001) and total adverse events (OR: 0.34; CI 0.20–0.59; p≤0.0001). EGBD is equally effective but safer than PTBD.

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Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage: predictors of successful outcome in patients who fail endoscopic retrograde cholangiopancreatography

Cited by 104 publications

References 34 publications

Comparison of Ultrasound and Fluoroscopically Guided Percutaneous Transhepatic Biliary Drainage

Comparison of Ultrasound and Fluoroscopically Guided Percutaneous Transhepatic Biliary Drainage

Preoperative biliary drainage for pancreatic cancer

Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage after failed endoscopic retrograde cholangiopancreatography: a meta-analysis

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