Apr 16, 2018

EUS-Guided Biliary Drainage for Unresectable Malignant Biliary Obstruction: 10-Year Experience of 99 Cases at a Single Center

Journal of Gastrointestinal Cancer
Yoshihide KannoKei Ito

Abstract

To evaluate clinical outcomes of endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) for unresectable malignant biliary obstruction for cases in which endoscopic retrograde cholangiopancreatography (ERCP) failed at a high-volume center. All 99 EUS-BD cases of unresectable malignant biliary obstruction at Sendai City Medical Center between February 2007 and September 2017 were retrospectively evaluated. ERCP is strictly prioritized over EUS-BD during the study period, and EUS-BD was performed in cases wherein ERCP was impossible or ineffective. Technical success, clinical success, adverse events, and time to recurrence of biliary obstruction were evaluated. EUS-BD was technically successful in 98% of the patients (97/99). The clinical success rate was 93% (90/97). Adverse events that were definitely related to the procedure were observed in ten patients (10%; peritonitis in six, acute cholecystitis in four). Of six patients with bile peritonitis, four suffered from mild localized peritonitis that improved with conservative treatment, whereas two developed pan-peritonitis that improved with additional intervention. Other three patients with a poor performance status succumbed shortly after the successful EUS-BD, with a p...Continue Reading

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Mentioned in this Paper

Health Center
Follow-up
Cessation of Life
Stent, Device
Retrograde Degeneration
Recurrent Malignant Neoplasm
Hospitals, High-Volume
Bipolar Disorder
Evaluation
Adverse Event

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