EUS-Guided Biliary Drainage With One-Step Placement of a Fully Covered Metal Stent for Malignant Biliary Obstruction: A Prospective Feasibility Study

Park, Do Hyun; Koo, Ja Eun; Oh, Joo Young; Lee, Young Hee; Moon, Sung–Hoon; Lee, Sang Soo; Seo, Dong–Wan; Lee, Sung‐Koo; Kim, Myung–Hwan

doi:10.1038/ajg.2009.254

Cited by 171 publications

(155 citation statements)

References 24 publications

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“…biliary drainage (EUS-BD) has been increasingly reported in patients who underwent failed endoscopic transpapillary biliary drainage [2][3][4]. There are two main approach routes in EUS-BD: endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) and endoscopic ultrasoundguided hepaticogastrostomy (EUS-HGS).…”

mentioning

confidence: 99%

Multicenter retrospective study of endoscopic ultrasound-guided biliary drainage for malignant biliary obstruction in Japan

Kawakubo

Isayama

Kato

et al. 2013

J Hepatobiliary Pancreat Sci

211

189

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Background Endoscopic ultrasound-guided biliary drainage (EUS-BD) is considered to be an effective salvage procedure for failed endoscopic retrograde cholangiopancreatography in patients with unresectable malignant biliary obstruction. The aim of this retrospective study was to evaluate the efficacy and feasibility of EUS-BD. at seven tertiary-care referral centers in Japan were included. The primary outcome was the technical success rate, and the secondary outcomes were the incidence of complications, stent dysfunction rate, time to stent dysfunction, and overall survival. Results The technical success rate for both EUS-CDS and EUS-HGS was 95%. The reasons for technical failure were two failed dilations of the anastomosis in EUS-CDS and one puncture failure in EUS-HGS. The stent dysfunction rate and 3-month dysfunction-free patency rate were 21% and 80% for EUS-CDS and 32% and 51% for EUS-HGS. There were 12 (six in EUS-CDS and six in EUS-HGS) procedurerelated complications (19%): five cases of bile leakage (3/2), three stent misplacements (1/2), one pneumoperitoneum (1/0), two cases of bleeding (1/1), one perforation (1/0), and one biloma (0/1). Bile leakage was more frequently observed in patients who underwent plastic stent placement (11%) than in those with covered metal stents (4%). Conclusions This Japanese multicenter study revealed a high success rate in EUS-BD. However, the complication rate was as high as that in previous series. Covered metal stents may be useful to reduce bile leakage in EUS-BD.

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mentioning

confidence: 99%

Multicenter retrospective study of endoscopic ultrasound-guided biliary drainage for malignant biliary obstruction in Japan

Kawakubo

Isayama

Kato

et al. 2013

J Hepatobiliary Pancreat Sci

211

189

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“…[12][13][14][15][16] Endoscopic drainage of pancreatic pseudocysts has become an accepted alternative to surgery when intervention is indicated. 6 The advantages of endoscopic drainage compared to percutaneous drainage include the ability to place multiple internal drains through one puncture site and the avoidance of development of a pancreaticocutaneous fistula in pseudocysts that communicate with the pancreatic duct.…”

Section: Discussionmentioning

confidence: 99%

Single-Step EUS-Guided Transmural Drainage of Pancreatic Pseudocysts: Analysis of Technical Feasibility, Efficacy, and Safety

Ahn

Seo²,

Eum³

et al. 2010

Gut Liver

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Background/Aims: With the progress of product development, single-step endoscopic ultrasound (EUS)-guided transmural drainage can overcome some disadvantages of the blind or two-step procedures used in the treatment of pancreatic pseudocysts. We therefore evaluated the technical feasibility, efficacy, and safety of single-step EUS-guided transmural drainage of pancreatic pseudocysts. Methods: Endoscopic drainage of pancreatic pseudocysts was performed in 47 patients (median age, 46 years; range, 38 years to 59 years; 40 men) by using interventional echoendoscopes with a single-step device suitable for ballooning, bougination, and plastic-stent insertion. Results: Endoscopic stent placement was successful in 42 patients (89%; transgastric approach, 34/38; transduodenal approach, 8/9) and failed in 5 patients because of acute angulation (n=4) or small cyst (n=1). The volume of the pseudocyst was reduced by more than 90% or it disappeared completely in all of 41 patients (100%), based on a mean follow-up period of 17 months (range, 11 months to 20 months). The overall recurrence rate was 12% (5/41) after improvement by the procedure. Minor complications (one case of bleeding, three cases of pneumoperitoneum, and one case of peritonitis) occurred after the procedure in five patients (11%), but there were no major complications. Conclusions: Single-step EUS-guided transmural drainage can be used to treat pancreatic pseudocysts with acceptable feasibility, efficacy, and safety. (Gut Liver 2010;4:524-529)

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“…In a report by Bories et al (7), including 10 cases which underwent transenteric ESBD with plastic and covered metal stents, biloma and cholangitis caused by stent migration or shorting occurred in 2 of 3 patients who had undergone one-step placement of a covered SEMS. Recently, Park et al (13,14) reported one-step placement of a fully-covered SEMS via the stomach or duodenum to the intra/extra-hepatic bile duct. There were no complications such as bile leakage and stent migration.…”

Section: Discussionmentioning

confidence: 99%

One-step Placement of a Fully-covered Metal Stent in Endosonography-guided Biliary Drainage for Malignant Biliary Obstruction

et al. 2011

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Background Although reports on endosonography-guided biliary drainage (ESBD) have been increasing, only a few discuss deployment of a self-expandable metal stent (SEMS) in the first session. Objective To evaluate the safety and efficacy of ESBD with the one-step placement of a newly designed fully-covered SEMS. Patient and MethodsFive patients with malignant biliary obstruction in whom one-step placement of an anti-migration designed SEMS in the first session of ESBD had been attempted between January 2007 and October 2009 were included in this study. Main outcome measurements were technical and clinical successes, early complications, and short-term results. Results ESBD was attempted to bridge the extrahepatic bile duct and the duodenum and one-step SEMS placement was successful in all cases. There were no early complications related to ESBD and excellent biliary decompression was obtained in all cases. SEMS dysfunction such as stent migration and occlusion was not seen during the follow-up period (mean follow-up 138 days, range 102-184 days). Conclusion One-step placement of a fully-covered SEMS in ESBD is possibly a safe and effective treatment for biliary obstruction.

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EUS-Guided Biliary Drainage With One-Step Placement of a Fully Covered Metal Stent for Malignant Biliary Obstruction: A Prospective Feasibility Study

Abstract: EUSBD with one-step placement of an FCSEMS may be feasible, safe, and effective as an alternative to PTBD in cases of malignant biliary obstruction when ERCP is unsuccessful. Prospective randomized trials of EUSBD with plastic stent vs. EUSBD with FCSEMS may be needed.

Cited by 171 publications

References 24 publications

Multicenter retrospective study of endoscopic ultrasound-guided biliary drainage for malignant biliary obstruction in Japan

Multicenter retrospective study of endoscopic ultrasound-guided biliary drainage for malignant biliary obstruction in Japan

Single-Step EUS-Guided Transmural Drainage of Pancreatic Pseudocysts: Analysis of Technical Feasibility, Efficacy, and Safety

One-step Placement of a Fully-covered Metal Stent in Endosonography-guided Biliary Drainage for Malignant Biliary Obstruction

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