EUS-guided drainage of hepatic abscess and infected biloma using short and long metal stents (with videos).

BACKGROUND: Currently, few reports exist on EUS-guided hepatic abscess drainage (EUS-HAD) and EUS-guided biloma drainage (EUS-BLD) using a metal stent. OBJECTIVE: We evaluated the technical success rate and efficacy of EUS-HAD and EUS-BLD for patients with hepatic abscess (HA) and infected biloma. DESIGN: Retrospective case series. SETTING: Single tertiary referral medical center. PATIENTS: We evaluated 7 HA and 6 infected biloma patients who were treated between August 2013 and August 2014 at Tokyo Medical University Hospital. INTERVENTIONS: EUS-HAD or EUS-BLD using a short (length, 2 or 3 cm) or long (length, 6 or 8 cm) self-expandable fully covered metal stent. MAIN OUTCOME MEASUREMENTS: Technical success, clinical success, and adverse event. RESULTS: The overall technical success rate was 100% in both EUS-HAD and EUS-BLD. The clinical success rates of EUS-HAD and EUS-BLD at the first session were 71.4% and 83.3%, respectively. Direct endoscopic necrosectomy was required in 1 case each of HA and infected biloma. The final clinical success rate was 100%. There were no procedure-related adverse events or cases of recurrence during the follow-up period (median, 83.5 days; range, 24-396 days). LIMITATIONS: Small sample size and no control group. CONCLUSIONS: EUS-HAD and EUS-BLD using a metal stent can be performed safely and effectively for HA and infected biloma.