The Spectrum of Endoscopic Ultrasound Intervention in Biliary Diseases: A Single Center’s Experience in 31 Cases

Abstract

Background and Aim. EUS-guided intervention (EGI) for biliary therapy has been increasingly used in recent years. This report aims to describe the spectrum and experience of EUS-guided interventions in biliary diseases in a single-tertiary center. Methods. All patients with EGI were analyzed retrospectively by retrieving data from a prospectively stored endoscopic database between January 2006 and September 2010. Results. There were 31 cases with EGIs (17 female, 14 male) with a mean age ± SD of 58.03 ± 16.89 years. The majority of cases (17/31; 55%) were ampullary or pancreatic cancers with obstructive jaundice. The major indications for EGI were obstructive jaundice (n = 16) and cholangitis (n = 9). The EGIs were technically successful in 24 of the 31 cases (77%). The success rate for the first 3 years was 8 of 13 procedures (61.5%) as compared to that of the last 2 years (16/18 procedures (89%); P = 0.072). Twenty-three of the 24 cases (96%) with technical success for stent placement also had clinical success in terms of symptom improvement. The complications were major in 4 (13%) and minor in 7 (23%) patients. Conclusion. The EUS-guided drainage for biliary obstruction, acute cholecystitis, bile leak, and biloma was an attractive alternative and should be handled in expert centers.

Endoscopic ultrasonography-guided biliary drainage: an alternative to percutaneous transhepatic puncture

“…The average clinical success rate was 90.9% (100/110). There were 11 5 NK BD PS 100 ( 19 5 26 12 19G NK, balloon CMS 75 (9/12) 100 (9/9) d 100 (9/9) 8 (1/12) d 11 (1/9) Pneumoperitoneum Kawakubo 27 2 19G BD, balloon PS 100 28 1 19G NK, BD PS 100 (1/1) 100 (1/1) 29 9 Adverse events Twenty one papers described complications related to EUS-HGS. The average complication rate related to EUS-HGS was 17.0% (26/153).…”

A giant and insidious subphrenic biloma formation due to gallbladder perforation mimicking biliary cystic tumor: A case report

“…Typically small and asymptomatic bilomas can be monitored periodically whereas, in cases with large-sized and infected lesions, or where the patient is medically unfit for surgery, percutaneous drainage is the appropriate approach, and may suffice for the evacuation of bilomas. Adjunct therapies, including percutaneous transhepatic biliary drainage (PTBD) and an endoscopic technique, are mandatory to facilitate healing of the defect in persistent cases, and these yield satisfactory results (15,27,28). As a general rule, endoscopic intervention is responsive for perforations located distally to the confluence of the left and right hepatic duct, whereas PTBD is responsive for perforations located proximally to the confluence.…”

Endoscopic Guided Biliary Drainage: How Can We Achieve Efficient Biliary Drainage?

“…However the data, as seen in Table 1, is promising as the cumulative success rate for extrahepatic EUS-BD is approximately 93% over the past 12 years 9,17-55Table 2 summarizes the published literature on intrahepatic EUS-BD, which shows a cumulative success rate of 84% 9,18,21,30,32,34,38,41,46,49-51,56,57…”