Jun 12, 2014

Comparison of endosonography-guided vs. percutaneous biliary stenting when papilla is inaccessible for ERCP

United European Gastroenterology Journal
Amol BapayeAdvay Aher


Endoscopic retrograde cholangiopancreatography (ERCP) and biliary stenting fails in 5-10% patients of malignant biliary obstruction because papilla is inaccessible. Percutaneous transhepatic biliary drainage (PTBD) is an accepted alternative. Endosonography-guided biliary drainage (EUS-BD) has been described recently. To compare success rates and complications of EUS-BD and PTBD internal stenting. This retrospective study included failed ERCP in inoperable malignant biliary obstruction due to inaccessible papilla undergoing PTBD or EUS-BD. Percutaneous transhepatic cholangiography guided/EUS-guided rendezvous procedures were excluded. When PTBD internal stenting failed, external drainage was performed. EUS-BD was performed using either intra- or extrahepatic approach, and stents were placed by transmural (choledocho-duodenostomy or hepatico-gastrostomy) or antegrade approach. Self-expandable metallic stents or plastic stents were placed in both groups. Success of internal stenting and complications were compared using t-test and chi-squared test. Retrospective review of 6 years of records (2005-2011) revealed 50 patients meeting the required criteria. EUS-BD was attempted in 25 and PTBD in 26 patients (one crossover from EUS-BD...Continue Reading

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Mentioned in this Paper

Retrograde Degeneration
Papilla of Tongue
Endoscopic Ultrasound
Malignant Paraganglionic Neoplasm
Stent Occlusion
Gastrostomy Site
Papilla of Duodenum
Percutaneous Transhepatic Cholangiography
Anaplastic Oligodendroglioma

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