title: Initial experience with EUS-guided cholangiopancreatography for biliary and pancreatic duct drainage: a Spanish national survey.
abstract: BACKGROUND
  EUS-guided cholangiopancreatography (ESCP) allows transmural access to biliopancreatic ducts when ERCP fails. Data regarding technical details, safety, and outcomes of ESCP are still unknown.
  
  
  OBJECTIVE
  To evaluate outcomes of ESCP in community and referral centers at the initial development phase of this procedure, to identify the ESCP stages with higher risk of failure, and to evaluate the influence on outcomes of factors related to the endoscopist.
  
  
  METHODS
  Multicenter retrospective study.
  
  
  METHODS
  Public health system hospitals with experience in ESCP in Spain.
  
  
  METHODS
  A total of 125 patients underwent ESCP in 19 hospitals, with an experience of <20 procedures.
  
  
  METHODS
  ESCP.
  
  
  METHODS
  Technical success and complication rates in the initial phase of implantation of ESCP are described. The influence of technical characteristics and endoscopist features on outcomes was analyzed.
  
  
  RESULTS
  A total of 125 patients from 19 hospitals were included. Biliary ESCP was performed in 106 patients and pancreatic ESCP was performed in 19. Technical success was achieved in 84 patients (67.2%) followed by clinical success in 79 (63.2%). Complications occurred in 29 patients (23.2%). Unsuccessful manipulation of the guidewire was responsible for 68.2% of technical failures, and 58.6% of complications were related to problems with the transmural fistula.
  
  
  CONCLUSIONS
  Retrospective study.
  
  
  CONCLUSIONS
  Outcomes of ESCP during its implantation stage reached a technical success rate of 67.2%, with a complication rate of 23.2%. Intraductal manipulation of the guidewire seems to be the most difficult stage of the procedure.
authors.affiliation: Department of Gastroenterology, Endoscopy Unit A, Complejo Hospitalario de Navarra, Pamplona, Spain. juanjvila@gmail.com
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Vila
authors.forename: Manuel
authors.initials: M
authors.lastname: Pérez-Miranda
authors.forename: Enrique
authors.initials: E
authors.lastname: Vazquez-Sequeiros
authors.forename: Monder Abu-Suboh
authors.initials: MA
authors.lastname: Abadia
authors.forename: Antonio
authors.initials: A
authors.lastname: Pérez-Millán
authors.forename: Ferrán
authors.initials: F
authors.lastname: González-Huix
authors.forename: Joan
authors.initials: J
authors.lastname: Gornals
authors.forename: Julio
authors.initials: J
authors.lastname: Iglesias-Garcia
authors.forename: Carlos
authors.initials: C
authors.lastname: De la Serna
authors.forename: José R
authors.initials: JR
authors.lastname: Aparicio
authors.forename: José C
authors.initials: JC
authors.lastname: Subtil
authors.forename: Alberto
authors.initials: A
authors.lastname: Alvarez
authors.forename: Felipe
authors.initials: F
authors.lastname: de la Morena
authors.forename: Jesús
authors.initials: J
authors.lastname: García-Cano
authors.forename: María A
authors.initials: MA
authors.lastname: Casi
authors.forename: Angel
authors.initials: A
authors.lastname: Lancho
authors.forename: Angel
authors.initials: A
authors.lastname: Barturen
authors.forename: Santiago J
authors.initials: SJ
authors.lastname: Rodríguez-Gómez
authors.forename: Alejandro
authors.initials: A
authors.lastname: Repiso
authors.forename: Diego
authors.initials: D
authors.lastname: Juzgado
authors.forename: Francisco
authors.initials: F
authors.lastname: Igea
authors.forename: Ignacio
authors.initials: I
authors.lastname: Fernandez-Urien
authors.forename: Juan A
authors.initials: JA
authors.lastname: González-Martin
authors.forename: José R
authors.initials: JR
authors.lastname: Armengol-Miró
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D002758:Cholangiography / Q000379:methods*; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000379:methods*; D019160:Endosonography; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D013030:Spain; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional