Different options of endosonography-guided biliary drainage after endoscopic retrograde cholangio-pancreatography failure

World Journal of Gastrointestinal Endoscopy
José Celso ArdenghJosé Sebastião Dos Santos

Abstract

To investigate the success rates of endosonography (EUS)-guided biliary drainage (EUS-BD) techniques after endoscopic retrograde cholangiopancreatography (ERCP) failure for management of biliary obstruction. From Feb/2010 to Dec/2016, ERCP was performed in 3538 patients, 24 of whom (0.68%) suffered failure to cannulate the biliary tree. All of these patients were initially submitted to EUS-guided rendez-vous (EUS-RV) by means of a transhepatic approach. In case of failure, the next approach was an EUS-guided anterograde stent insertion (EUS-ASI) or an EUS-guided hepaticogastrostomy (EUS-HG). If a transhepatic approach was not possible or a guidewire could not be passed through the papilla, EUS-guided choledochoduodenostomy (EUS-CD) was performed. Patients were submitted to EUS-RV (7), EUS-ASI (5), EUS-HG (6), and EUS-CD (6). Success rates did not differ among the various EUS-BD techniques. Overall, technical and clinical success rates were 83.3% and 75%, respectively. Technical success for each technique was, 71.4%, 100%, 83.3%, and 83.3%, respectively (P = 0.81). Complications occurred in 3 (12.5%) patients. All of these cases were managed conservatively, but one patient died after rescue percutaneous transhepatic biliary drai...Continue Reading

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Citations

Jul 15, 2020·Scandinavian Journal of Gastroenterology·Giulia MarchettiJosé Celso Ardengh
Nov 16, 2019·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·De-Feng LiDuo-Wu Zou
May 1, 2020·Clinical and Translational Gastroenterology·Anna FábiánZoltán Szepes
Jun 18, 2019·World Journal of Gastrointestinal Endoscopy·En-Ling Leung Ki, Bertrand Napoleon

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Methods Mentioned

BETA
sedation
biopsy

Software Mentioned

SAS

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