Long-term outcomes of EUS-guided choledochoduodenostomy using a lumen-apposing metal stent for malignant distal biliary obstruction: a prospective multicenter study

Tsuchiya, Takayoshi; Teoh, Anthony Yuen Bun; Itoi, Takao; Yamao, Kenji; Hara, Kazuo; Nakai, Yousuke; Isayama, Hiroyuki; Kitano, Masayuki

doi:10.1016/j.gie.2017.08.017

Cited by 130 publications

(147 citation statements)

References 23 publications

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“…Thirteen original articles were considered appropriate to be included in this review article [13-25]. In our review, we included 10 case reports – 2 from Spain [16, 20], 3 from Japan [17-19], 4 from the United States [14, 15, 21, 22], and 1 from Italy [13].…”

Section: Resultsmentioning

confidence: 99%

“…In addition, we included 2 case series – one of which comes from Italy [23] while the other one was a multicenter study from Germany, Denmark, Italy, and Spain [24]. A prospective multicenter study from Japan and Hong-Kong was also included in our review [25]. …”

Section: Resultsmentioning

confidence: 99%

“…A majority of patients (90/92) had malignant biliary obstruction [13-17, 20-25]. Pancreatic cancer was the most common type, whereas duodenal, ampullary, gastric, cholangiocarcinoma, sarcoma, and metastatic cancer (renal, colon, breast, or uterine) attributed to the rest [13-17, 20-25].…”

Section: Discussionmentioning

confidence: 99%

“…Pancreatic cancer was the most common type, whereas duodenal, ampullary, gastric, cholangiocarcinoma, sarcoma, and metastatic cancer (renal, colon, breast, or uterine) attributed to the rest [13-17, 20-25]. One patient had benign biliary obstruction secondary to stenosis at the site of choledochojejunostomy from prior whipple surgery [18] and another patient presented with recurrent cholangitis due to intrahepatic bile duct stones who had surgical cholecystoduodenostomy for congenital biliary atresia as a child [19].…”

Section: Discussionmentioning

confidence: 99%

“…The references to relevant studies were manually searched to identify additional relevant studies. The search yielded case reports [13-22], case series [23, 24], and a prospective multicenter study [25]. The indication for procedure, prior interventions, patient characteristics, LAMS specifics, procedure details, technical and clinical success rates, complications with their management, and limitations of each study were reviewed and have been summarized in Table 1.…”

Section: Methodsmentioning

confidence: 99%

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Endoscopic Ultrasound Guided Choledocho-Enterostomy by Using Lumen Apposing Metal Stent in Patients with Failed Endoscopic Retrograde Cholangiopancreatography: A Literature Review

et al. 2018

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Background: Endoscopic retrograde cholangiopancreatography (ERCP) has been the cornerstone in the management of malignant jaundice to provide symptomatic relief and/or to allow chemotherapy. Difficult biliary cannulation or the presence of concomitant duodenal obstruction may lead to its failure. Method: An extensive English literature search was done via PubMed and Google Scholar to identify 13 peer-reviewed original articles. Results: Of 92 patients, 98.9% (91/92) successfully underwent EUS-guided biliary drainage by placement of a lumen-apposing metal stent (LAMS) across extrahepatic biliary tree and small bowel. Although technically challenging, a similar technical success was noted for patients with limited dilation of extrahepatic biliary tree (less than 1 cm) and altered gastrointestinal anatomy (Roux-en-Y, Whipple, or Billroth II). Of 91 patients, 98.9% (90/91) had clinical success. Procedure complications included perforation (2/92; 2.2%) and bleeding (1/92; 1.1%). Stent complications included obstruction (7/91; 7.7%), and migration (1/91; 1.1%) with all responding to endoscopic debridement of food or tumor, placement of plastic pigtail stent through the LAMS, or replacement with a new stent. No procedure-related mortality was noted. Conclusion: In the hands of an expert, EUS-guided biliary drainage with the use of LAMS is an efficacious and safe option for patients with distal malignant biliary stricture, not amenable to ERCP.

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