Abstract
This study aimed to evaluate the feasibility of endoscopic ultrasound (EUS)-guided antegrade covered stent placement with long duodenal extension (EASL) for malignant distal biliary obstruction (MDBO) with duodenal obstruction (DO) or surgically altered anatomy (SAA) after failed endoscopic retrograde cholangiopancreatography (ERCP). Outcomes were technical and clinical success, reintervention rate, adverse events, stent patency, and overall survival. Inverse probability of treatment weighting (IPTW) and competing-risk analysis were performed to compare with conventional EUS-BD. Twenty-five patients (DO, n = 18; SAA, n = 7) were included. The technical and clinical success rates were 96% and 84%, respectively. Reintervention occurred in two patients (8.3%). Adverse events occurred in six patients (24%; two cholangitis, 16%; four mild postprocedural pancreatitis [24% (n = 4/17) in patients with non-pancreatic cancers]). The median patency was 9.4 months, and the overall survival was 2.73 months. After IPTW adjustment, the median patency in the EASL (n = 25) and conventional EUS-BD (n = 29) were 10.1 and 6.5 months, respectively (P = .018). EASL has acceptable clinical outcomes with a low reintervention rate but higher rate of po...Continue Reading
References
Jun 23, 2009·Gastrointestinal Endoscopy·Sri Prakash Misra, Manisha Dwivedi
Mar 2, 2010·Gastrointestinal Endoscopy·Peter B CottonJohn J Vargo
Nov 22, 2011·Digestive Diseases and Sciences·Byoung Wook BangSung-Gwon Kang
Mar 26, 2013·Gastrointestinal Endoscopy·Do Hyun ParkMyung-Hwan Kim
Dec 18, 2014·Journal of Clinical Gastroenterology·Simon NennstielBruno Neu
Sep 19, 2015·Gastrointestinal Endoscopy·Mouen A KhashabEverson L A Artifon
Jan 9, 2017·Gastrointestinal Endoscopy·Reem Z SharaihaMichel Kahaleh
Mar 14, 2017·Therapeutic Advances in Gastroenterology·Dongwook OhMyung-Hwan Kim
Mar 10, 2018·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Dong Il GwonKyu-Bo Sung
Jul 3, 2018·The American Journal of Gastroenterology·Woo Hyun PaikMyung-Hwan Kim
Aug 8, 2018·Endoscopy·Jean-Marc DumonceauJeanin E van Hooft
Aug 22, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Masanori YamadaKazuhide Higuchi
Dec 12, 2018·Endoscopic Ultrasound·Kenjiro YamamotoYuichi Nagakawa
Apr 27, 2019·Journal of Hepato-biliary-pancreatic Sciences·Hiroyuki IsayamaKazuo Inui
Jun 21, 2019·Gastrointestinal Endoscopy·Tae Hoon LeeDo Hyun Park
Dec 13, 2019·Journal of Gastroenterology and Hepatology·Seung Hwan ShinDo Hyun Park
Apr 13, 2020·Gastrointestinal Endoscopy·Yousuke NakaiKazuhiko Koike