Dec 9, 2014

Multicenter comparative evaluation of endoscopic placement of expandable metal stents for malignant distal common bile duct obstruction by ERCP or EUS-guided approach

Gastrointestinal Endoscopy
Vinay DhirAmit Maydeo

Abstract

A single session of EUS-guided biliary drainage (EUS-BD) may be a viable alternative to ERCP in patients with malignant distal common bile duct (CBD) obstruction. There is no study comparing EUS-BD and ERCP for the relief of distal malignant biliary obstruction. To compare the outcomes of self-expandable metal stent (SEMS) placement for malignant distal biliary obstruction by using ERCP and EUS-BD. Multicenter, retrospective analysis. Tertiary referral centers. Patients with malignant distal CBD obstruction requiring SEMS placement. Patients in the EUS-BD group underwent EUS-guided choledochoduodenostomy (EUS-CDS) or EUS-guided antegrade (EUS-AG) procedures after 1 or more failed ERCP attempts. Patients in the ERCP group underwent retrograde SEMS placement. Composite success (the ability to complete the intended therapeutic procedure in a single session and resulting in a greater than 50% decrease in bilirubin over 2 weeks). The study included 208 patients, 104 treated with ERCP and 104 treated with EUS-BD (68 EUS-CDS, 36 EUS-AG). SEMS placement was successful in 98 patients in the ERCP group and 97 in the EUS-BD group (94.23% vs 93.26%, P = 1.00). The frequency of adverse events in the ERCP and EUS-BD groups was 8.65% and 8.65...Continue Reading

  • References17
  • Citations29

Citations

Mentioned in this Paper

Anastomosis, Surgical
perfluoro-2,2,2',2'-tetramethyl-4,4'-bis(1,3-dioxolane)
Jaundice, Obstructive
Pancreatic Carcinoma
Biliary Atresia
Pancreatitis
Bilirubin
Operative Time
Duodenum
Malignant Neoplasm of Pancreas

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