Endoscopic ultrasound-guided gallbladder drainage as a rescue therapy for unresectable malignant biliary obstruction: a multicenter experience.
Endoscopy
; 53(8): 827-831, 2021 08.
Article
em En
| MEDLINE
| ID: mdl-32898918
ABSTRACT
BACKGROUND:
Endoscopic retrograde cholangiopancreatography (ERCP) is often unsuccessful in patients with duodenal stenosis or malignant ampullary infiltration. While endoscopic ultrasound-guided biliary drainage (EUS-BD) has been proposed as an alternative, EUS-guided gallbladder drainage (EUS-GBD) is an attractive option when both approaches fail. We aimed to assess the effectiveness and safety of EUS-GBD as rescue therapy for malignant distal bile duct obstruction.METHODS:
A multicenter retrospective study was performed on patients with unresectable malignant distal bile duct obstruction who underwent EUS-GBD between 2014 and 2019 after unsuccessful ERCP and EUS-BD. Clinical success was defined as a decrease in serum bilirubin of >â50â% within 2 weeks.RESULTS:
28 patients were included, with a lumen-apposing metal stent used in 26 (93â%) and a self-expandable metal stent in two (7â%). The technical success rate was 100â%. The clinical success rate was 93â%, with an improvement in bilirubin (7.3 [SD 5.4] pre-procedure vs. 2.8 [SD 1.1] post-procedure; Pâ=â0.001). Delayed adverse events included food impaction of the stent (nâ=â3), with a further two patients developing cholecystitis and bleeding.CONCLUSION:
This study demonstrates the feasibility of gallbladder drainage to relieve malignant distal bile duct obstruction in patients with failed ERCP and EUS-BD.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Colestase
/
Vesícula Biliar
Tipo de estudo:
Etiology_studies
/
Observational_studies
Limite:
Humans
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Estados Unidos