Endoscopic ultrasound-guided drainage of the biliary system: Techniques, indications and future perspectives

Hindryckx, Pieter; Degroote, Helena; Tate, David J.; Deprez, Pierre Henri

doi:10.4253/wjge.v11.i2.103

Cited by 18 publications

(30 citation statements)

References 68 publications

(77 reference statements)

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“…The current recommended technique by most authors includes 19G needle puncture of the extrahepatic bile duct from the duodenal bulb or second duodenal portion, with the endoscope in the short position, and passage of a 0.025-inch guidewire. [ 24 ]…”

Section: Eus and Endoscopic Retrograde Cholangiopancreatography Collamentioning

confidence: 99%

EUS and ERCP: A rationale categorization of a productive partnership

2021

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ERCP and EUS are complementary techniques in the management of biliary and pancreatic diseases. Combination of these two techniques can reach different levels of complexity with increasing rates of adverse events. In this article we propose a categorization of the relationship between EUS and ERCP based on whether EUS indicates, complements, facilitates or replaces ERCP. It has implications for the complexity of the technique, the training of the endoscopist and the necessary hospital resources. This classification can also be useful in planning endoscopist training and patient management.

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Section: Eus and Endoscopic Retrograde Cholangiopancreatography Collamentioning

confidence: 99%

EUS and ERCP: A rationale categorization of a productive partnership

2021

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“…There are different approaches for EUS-BD, indication for which depends on the etiology (malignant or benign), location (distal or proximal) of the biliary obstruction and the upper gastrointestinal tract anatomy (surgically altered or not). Prerequisite for endoscopic EUS-BD is the visualization of the dilated extra—and/or intrahepatic bile ducts, respectively, followed by the puncture of the target duct with a needle or a dedicated access device (i.e., LAMS) [ 33 ]. Access to the left intrahepatic bile ducts is usually attempted from the oral part of the stomach whereas the optimal position to sight out the CBD is the apical duodenum.…”

Section: Clinical Application and Performance Of Eus In Biliary DImentioning

confidence: 99%

Clinical Management of Bile Duct Diseases: Role of Endoscopic Ultrasound in a Personalized Approach

Beyna

Gerges

2020

JPM

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Biliary diseases are common, but clinical symptoms are often unspecific and direct access and visualization of the biliopancreatic system for diagnostic purpose is difficult. In the last decades endoscopic ultrasound (EUS) has become a primary method in the gastrointestinal tract. It significantly changed the role of endoscopy in diagnostic imaging in the gastrointestinal tract and adjacent organs. EUS has become an effective diagnostic tool in biliary stone disease as well as in the diagnosis of indeterminate biliary strictures. Furthermore, an EUS-directed transmural approach emerged as a safe and effective alternative to ERCP in patients requiring biliary drainage, in particular as a backup method if standard ERCP-approach fails. Development of new techniques, specific accessories and stents during the last decade led to an enormous step forward in terms of efficacy and safety of an EUS-directed approach. In the current article technical and clinical aspects of EUS-guided diagnostic and therapeutic approaches in different clinical indications will be discussed together with a review of the available data.

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“…However, the rendezvous maneuver can fail because of an inaccessible papilla (altered anatomy, duodenal obstruction, gastric outlet syndrome or the presence of enteral stents) or a failure to advance the wire through a stricture. In these patients, HG or CD are feasible drainage techniques 132. Four meta-analyses reported that EUS-BD was clinically successful in 87–94% of cases with adverse events reported in 16–29% 133,134.…”

Section: Endoscopic Managementmentioning

confidence: 99%

<p>Early Diagnosis And Management Of Malignant Distal Biliary Obstruction: A Review On Current Recommendations And Guidelines</p>

Viesca¹,

Arvanitakis²

2019

CEG

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Malignant biliary obstruction is a challenging condition, requiring a multimodal approach for both diagnosis and treatment. Pancreatic adenocarcinoma and cholangiocarcinoma are the leading causes of malignant distal biliary obstruction. Early diagnosis is difficult to establish as biliary obstruction can be the first presentation of the underlying disease, which can already be at an advanced stage. Consequently, the majority of patients (70%) with malignant distal biliary obstruction are unresectable at the time of diagnosis. The association of clinical findings, laboratory tests, imaging, and endoscopic modalities may help in identifying the underlying cause. Novel endoscopic techniques such as cholangioscopy, intraductal ultrasonography, or confocal laser endomicroscopy have been developed with promising results, but are not used in routine clinical practice. As the number of patients with malignant distal biliary obstruction who will undergo curative surgery is limited, endoscopy has a crucial role in palliation, to relieve biliary obstruction. According to the last European guidelines published in the management of biliary obstruction, self-expandable metal stents have a central place in biliary drainage compared to plastic stents. Endoscopic ultrasound has evolved impressively in the last decades. When standard techniques of biliary cannulation by endoscopic retrograde cholangiopancreatography fail, endoscopic ultrasound-guided biliary drainage is a good option compared to percutaneous drainage.

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Endoscopic ultrasound-guided drainage of the biliary system: Techniques, indications and future perspectives

Cited by 18 publications

References 68 publications

EUS and ERCP: A rationale categorization of a productive partnership

EUS and ERCP: A rationale categorization of a productive partnership

Clinical Management of Bile Duct Diseases: Role of Endoscopic Ultrasound in a Personalized Approach

<p>Early Diagnosis And Management Of Malignant Distal Biliary Obstruction: A Review On Current Recommendations And Guidelines</p>

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