Endoscopic ultrasound-guided gallbladder drainage by transduodenal lumen-apposing metal stent in a patient with Roux-en-Y reconstruction

Anderloni, Andrea; Fugazza, Alessandro; Maroni, Luca; Troncone, Edoardo; Milani, Olivia; Cappello, Annalisa; Alkandari, Asma; Repici, Alessandro

doi:10.20524/aog.2019.0384

Cited by 5 publications

(3 citation statements)

References 10 publications

(13 reference statements)

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“…Although different aforementioned techniques have been proposed over the years to perform biliopancreatic endoscopy in altered anatomy, improving technical success still needs some implementation and alternatives. Therefore, EUS-guided or assisted procedures to perform ERCP are increasing and many case reports without routine solutions have been reported over the years [ 55 , 56 , 57 , 58 , 59 ], both to get access to the biliary limb and for directly performing the procedure. Recently, a water-filled diagnostic and therapeutic EUS procedure has been proposed for patients with Billroth II or Roux-en-Y reconstruction, in order to achieve a higher success rate and lower adverse event rate, but few cases are described in literature to properly understand its efficacy [ 60 ].…”

Section: Resultsmentioning

confidence: 99%

Biliopancreatic Endoscopy in Altered Anatomy

Tarantino

Rizzo

2021

Medicina

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Background and Objectives: Anatomical post-surgical alterations of the upper gastrointestinal (GI) tract have always been challenging for performing diagnostic and therapeutic endoscopy, especially when biliopancreatic diseases are involved. Esophagectomy, gastrectomy with various reconstructions and pancreaticoduodenectomy are among the most common surgeries causing upper GI tract alterations. Technological improvements and new methods have increased the endoscopic success rate in these patients, and the literature has been rapidly increasing over the past few years. The aim of this systematic review is to identify evidence on the available biliopancreatic endoscopic techniques performed in the altered post-surgical anatomy of upper GI tract. Materials and Methods: We performed a systematic search of PubMed, MEDLINE, Cochrane Library, and SCOPUS databases. Study-level variables extracted were the last name of the first author, publication year, study design, number of patients, type of post-surgical anatomical alteration, endoscopic technique, success rate and endoscopic-related adverse events. Results: Our primary search identified 221 titles, which was expanded with studies after the citation search. The final full-text review process identified 52 articles (31 retrospective studies, 8 prospective studies and 13 case reports). We found several different techniques developed over the years for biliopancreatic diseases in altered anatomy, in order to perform both endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). They included enteroscopy-assisted ERCP (double and single balloon enteroscopy-ERCP, spiral enteroscopy-ERCP) laparoscopic assisted ERCP, EUS-Directed transgastric ERCP, EUS-directed transgastric intervention, gastric access temporary for endoscopy, and percutaneous assisted trans prosthetic endoscopic therapy. The success rate was high (most of the techniques showed a success rate over 90%) and a low rate of adverse events were reported. Conclusions: We suggest the considerationof the novel techniques when approaching patients with altered anatomy who require biliopancreatic endoscopy, focusing on the surgery type, success rate and adverse events reported in the literature.

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Section: Resultsmentioning

confidence: 99%

Biliopancreatic Endoscopy in Altered Anatomy

Tarantino

Rizzo

2021

Medicina

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“…Furthermore, TGBD could also be an effective and safe approach in patients with ascites, in whom both PGBD and EUS-GBD are more difficult and burdened with higher risks, or in patients with coagulopathy/anti-coagulant use, since a transpapillary stent does not require sphincterotomy for placement. On the other hand, EUS-GBD is the only possible endoscopic approach when the papilla is not reachable, such as in case of post-surgical anatomy or duodenal obstruction, or when the cystic duct is inaccessible (i.e., SEMS in place, neoplastic obstruction) [50,51] (Figure 5). Finally, EUS-GBD is the only approach that allows for subsequent safe and effective therapeutic interventions on the gallbladder, such as cholecystoscopy with stone extraction; therefore, EUS-GBD could be favored if such a need can be anticipated (e.g., patients with a large stone burden).…”

Section: Gallbladder Drainage In Acute Cholecystitis: Percutaneous Tr...mentioning

confidence: 99%

Endoscopic Gallbladder Drainage: A Comprehensive Review on Indications, Techniques, and Future Perspectives

Troncone,

Amendola,

Moscardelli

et al. 2024

Medicina

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In recent years, therapeutic endoscopy has become a fundamental tool in the management of gallbladder diseases in light of its minimal invasiveness, high clinical efficacy, and good safety profile. Both endoscopic transpapillary gallbladder drainage (TGBD) and endoscopic ultrasound (EUS)-guided gallbladder drainage (EUS-GBD) provide effective internal drainage in patients with acute cholecystitis unfit for cholecystectomy, avoiding the drawbacks of external percutaneous gallbladder drainage (PGBD). The availability of dedicated lumen-apposing metal stents (LAMS) for EUS-guided transluminal interventions contributed to the expansion of endoscopic therapies for acute cholecystitis, making endoscopic gallbladder drainage easier, faster, and hence more widely available. Moreover, EUS-GBD with LAMS opened the possibility of several cholecystoscopy-guided interventions, such as gallstone lithotripsy and clearance. Finally, EUS-GBD has also been proposed as a rescue drainage modality in malignant biliary obstruction after failure of standard techniques, with encouraging results. In this review, we will describe the TBGD and EUS-GBD techniques, and we will discuss the available data on clinical efficacy in different settings in comparison with PGBD. Finally, we will comment on the future perspectives of EUS-GBD, discussing the areas of uncertainty in which new data are more strongly awaited.

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“…

Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is effective for treating cholecystitis [1,2]; however, its application is challenging in patients with surgically altered anatomy [3]. In such patients, the forward-viewing echoendoscope (FV-EUS) is useful [4].Here, we report a case of a patient who underwent EUS-GBD using FV-EUS after Billroth II gastrectomy.

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mentioning

confidence: 99%

Endoscopic ultrasound-guided gallbladder drainage using a forward-viewing echoendoscope after Billroth II gastrectomy

Tozuka,

Sugimori,

Miwa

et al. 2024

Endoscopy

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Endoscopic ultrasound-guided gallbladder drainage by transduodenal lumen-apposing metal stent in a patient with Roux-en-Y reconstruction

Cited by 5 publications

References 10 publications

Biliopancreatic Endoscopy in Altered Anatomy

Biliopancreatic Endoscopy in Altered Anatomy

Endoscopic Gallbladder Drainage: A Comprehensive Review on Indications, Techniques, and Future Perspectives

Endoscopic ultrasound-guided gallbladder drainage using a forward-viewing echoendoscope after Billroth II gastrectomy

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