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Conversion to endoscopic ultrasound-guided biliary drainage by temporary nasobiliary drainage placement in patients with prior biliary stenting
- Source :
- Endoscopic Ultrasound
- Publication Year :
- 2017
- Publisher :
- Medknow Publications & Media Pvt Ltd, 2017.
-
Abstract
- Background and Objectives: Endoscopic ultrasound-guided biliary drainage (EUS-BD), first reported as an alternative to percutaneous transhepatic BD in failed endoscopic retrograde cholangiography, is sometimes performed as reintervention for transpapillary stent dysfunction such as in patients with new onset gastric outlet obstruction, but direct conversion to EUS-BD can potentially have a risk of leakage of infected bile. The aim of this study is to evaluate the safety and efficacy of conversion to EUS-BD using a temporary endoscopic nasobiliary drainage (ENBD) tube placement as a reintervention for prior BD. Patients and Methods: Sixteen patients with prior BD for malignant biliary obstruction undergoing conversion to EUS-BD using a temporary ENBD tube placement were studied. Technical and clinical success rate and adverse events were evaluated. Results: The major reason for conversion to EUS-BD was recurrent cholangitis due to duodenobiliary reflux (n = 13). In 14 patients with an indwelling covered metal or plastic stent, the stents were removed before temporary ENBD placement. After a median duration of 6 days, subsequent conversion to EUS-BD using a covered metal stent was performed, which was technically and clinically successful in all 16 patients (14 hepaticogastrostomy and 2 choledochoduodenostomy). Adverse events were observed in 3 patients (19%): one bleeding, one cholecystitis, and one cholangitis. No bile leak, peritonitis, or sepsis was observed. Conclusions: Conversion to EUS-BD using temporary ENBD tube placement in patients with prior BD was technically feasible and relatively safe without infectious complications related to bile leakage.
- Subjects :
- Endoscopic ultrasound
medicine.medical_specialty
Percutaneous
medicine.medical_treatment
Peritonitis
Biliary Stenting
Biliary drainage
03 medical and health sciences
0302 clinical medicine
medicine
malignant biliary obstruction
Radiology, Nuclear Medicine and imaging
Hepatology
medicine.diagnostic_test
business.industry
Gastroenterology
Reflux
Stent
Gastric outlet obstruction
medicine.disease
digestive system diseases
Surgery
030220 oncology & carcinogenesis
covered metal stent
endoscopic ultrasound
Cholecystitis
030211 gastroenterology & hepatology
Original Article
business
Subjects
Details
- Language :
- English
- ISSN :
- 22267190 and 23039027
- Volume :
- 6
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Endoscopic Ultrasound
- Accession number :
- edsair.doi.dedup.....fefb9c28f098a23c62de548fa121ea26