Jan 15, 2016

EUS-guided gallbladder drainage for rescue treatment of malignant distal biliary obstruction after unsuccessful ERCP

Gastrointestinal Endoscopy
Hajime ImaiMasatoshi Kudo

Abstract

EUS-guided bile duct drainage (EUS-BD) is a well-recognized rescue biliary drainage method after unsuccessful ERCP. EUS-guided gallbladder drainage (EUS-GBD) was recently used to treat acute cholecystitis. The aim of this study was to assess the efficacy and safety of EUS-GBD for malignant biliary stricture-induced obstructive jaundice after unsuccessful ERCP as well as unsuccessful or impractical EUS-BD. Between January 2006 and October 2014, 12 patients with obstructive jaundice due to unresectable malignant distal biliary stricture underwent EUS-GBD after ERCP failed. EUS-GBD was performed under the guidance of EUS and fluoroscopy by puncturing the gallbladder with a needle, inserting a guidewire, dilating the puncture hole, and placing a stent. The technical and functional success rates, adverse events rate, overall patient survival time, and stent dysfunction rate during patient survival were measured. The rates of technical success, functional success, adverse events, and stent dysfunction were 100%, 91.7%, 16.7%, and 8.3%, respectively. The median survival time after EUS-GBD was 105 days (range 15 - 236 days). EUS-GBD is a possible alternative route for decompression of the biliary system when ERCP is unsuccessful.

  • References22
  • Citations12

Citations

Mentioned in this Paper

Study
perfluoro-2,2,2',2'-tetramethyl-4,4'-bis(1,3-dioxolane)
Jaundice, Obstructive
Yellow Skin or Eyes (Symptom)
ABCB4
Entire Lumen of Body System
Needle Device
Advice
Entire Cystic Duct
Biliary Tract Structure

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