Prospective multicenter study of primary EUS-guided choledochoduodenostomy using a covered metal stent

Endoscopic Ultrasound
Yousuke NakaiTakao Itoi

Abstract

EUS-guided biliary drainage (EUS-BD) is increasingly reported as a salvage technique after failed endoscopic retrograde cholangiopancreatography, but it is still controversial whether EUS-BD can replace transpapillary biliary stenting. Therefore, we conducted this multicenter, prospective study of EUS-guided choledochoduodenostomy (EUS-CDS) using a covered metallic stent (CMS) as primary biliary drainage for unresectable distal malignant biliary obstruction (MBO). Patients with unresectable distal MBO without any prior drainage are enrolled. Primary endpoint is a technical success and secondary endpoints are adverse events, functional success, and recurrent biliary obstruction (RBO) of EUS-CDS. Clinical outcomes were compared between EUS-CDS and transpapillary stenting as a control. A total of 34 patients were enrolled in 10 Japanese institutions. The cause of MBO was pancreatic cancer in 28 patients. Median tumor size and common bile duct diameter were 31 and 13 mm, respectively. Technical success rate was 97% with a median procedure time of 25 min and functional success rate was 100%. The rate of RBO was 29% and the causes of RBO were nontumor related: Migration in 18%, sludge/food impaction in 9%, and stent impaction to the ...Continue Reading

Citations

Oct 23, 2019·Journal of Translational Internal Medicine·Guoxin WangSiyu Sun
Jul 10, 2020·Scandinavian Journal of Gastroenterology·Jinlong HuSiyu Sun
Dec 29, 2019·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Shimpei MatsumotoYasumasa Niwa
Jun 18, 2019·World Journal of Gastrointestinal Endoscopy·En-Ling Leung Ki, Bertrand Napoleon
Jun 18, 2019·World Journal of Gastrointestinal Endoscopy·Raffaele SalernoSandro Ardizzone
Nov 16, 2019·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·De-Feng LiDuo-Wu Zou
May 1, 2021·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Yunxiao LyuYuan Wang
Jan 15, 2022·Clinical Journal of Gastroenterology·Jahnvi Dhar, Jayanta Samanta

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Methods Mentioned

BETA
percutaneous transhepatic biliary drainage
sedation
X-ray

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