Clinical feasibility of endoscopic ultrasound-guided biliary drainage for preoperative management of malignant biliary obstruction (with videos).
J Hepatobiliary Pancreat Sci
; 30(7): 983-992, 2023 Jul.
Article
in En
| MEDLINE
| ID: mdl-36458423
ABSTRACT
BACKGROUND/PURPOSE:
EUS-guided biliary drainage (EUS-BD) has recently been reported to be a useful salvage technique after ERCP fail. However, data on EUS-BD used for preoperative biliary drainage (PBD) are limited. The aim of this study was to verify the clinical feasibility of EUS-BD for PBD.METHODS:
PBD was performed for malignant biliary obstruction in 318 patients at our institution between July 2014 and April 2022. Fifteen (4.7%) of these patients underwent surgical resection after preoperative EUS-BD (HGS 13; HDS 1; AGS with HGS 1) and were retrospectively analyzed.RESULTS:
The stent was successfully placed in all 15 cases with a median procedure time of 15 min (technical success rate 100%). The median total bilirubin value decreased significantly from 3.7 before drainage to 0.9 after surgery (p < .001) and cholangitis was well managed (clinical success rate 100%). Surgery was performed at a median of 22 days after drainage, and there were no stent-related adverse events or recurrences of biliary obstruction. Severe surgery-related adverse events occurred in three cases, but none were associated with EUS-BD. The stent was removed during surgery in 12 cases.CONCLUSIONS:
EUS-BD can be a feasible and safe alternative method of PBD for malignant biliary obstruction after ERCP fail.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cholestasis
/
Cholangiopancreatography, Endoscopic Retrograde
Limits:
Humans
Language:
En
Journal:
J Hepatobiliary Pancreat Sci
Year:
2023
Document type:
Article
Affiliation country:
Japan