Back to Search
Start Over
EUS-guided choledochoduodenostomy for malignant distal biliary obstruction after failed ERCP: a retrospective nationwide analysis.
- Source :
-
Gastrointestinal endoscopy [Gastrointest Endosc] 2022 May; Vol. 95 (5), pp. 896-904.e1. Date of Electronic Publication: 2022 Jan 04. - Publication Year :
- 2022
-
Abstract
- Background and Aims: EUS-guided choledochoduodenostomy (EUS-CDS) with a lumen-apposing metal stent (LAMS) has been proposed as an alternative procedure in patients with distal malignant biliary obstruction (DMBO) and failed ERCP.<br />Methods: This multicenter, retrospective analysis included all cases of EUS-CDS with LAMS performed in patients with DMBO and failed ERCP in 23 Italian centers from January 2016 to July 2020. Primary endpoints were technical and clinical success. Secondary endpoints were the assessment of the adverse event (AE) rate and variables associated with technical success.<br />Results: Two hundred fifty-six patients (44.9% women) with a mean age of 73.9 ± 12.6 years were included in the study. The most common etiology of DMBO was pancreatic adenocarcinoma (75%), followed by ampullary cancer (8.6%) and cholangiocarcinoma (6.6%). The common bile duct median diameter was 17.3 ± 3.9 mm. Technical and clinical success were achieved in 239 of 256 (93.3%), and 230 of 239 (96.2%) patients, respectively. The mean follow-up was 151 ± 162 days. Twenty-seven AEs occurred in 25 of 239 patients (10.5%) (3 mild, 21 moderate, and 3 severe). No fatal AEs occurred. Reinterventions to manage AEs with endoscopic or radiologic procedures occurred in 22 patients (9.2%).<br />Conclusions: The results of our study show that EUS-CDS with LAMSs in patients with DMBO and failed ERCP represent a viable alternative in terms of effectiveness and safety with acceptable AE rates. (Clinical trial registration number: NCT03903523.).<br /> (Copyright © 2022 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
Bile Ducts, Intrahepatic
Cholangiopancreatography, Endoscopic Retrograde methods
Choledochostomy methods
Drainage methods
Endosonography methods
Female
Humans
Male
Middle Aged
Retrospective Studies
Stents adverse effects
Ultrasonography, Interventional adverse effects
Adenocarcinoma complications
Adenocarcinoma surgery
Ampulla of Vater
Bile Duct Neoplasms complications
Cholestasis complications
Cholestasis surgery
Common Bile Duct Neoplasms complications
Common Bile Duct Neoplasms surgery
Pancreatic Neoplasms complications
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6779
- Volume :
- 95
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Gastrointestinal endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 34995640
- Full Text :
- https://doi.org/10.1016/j.gie.2021.12.032