Endoscopic Ultrasound-Guided Biliary Drainage Using a Fully Covered Metallic Stent after Failed Endoscopic Retrograde Cholangiopancreatography.
Background and Study Aims. Endoscopic ultrasound- (EUS-) guided biliary drainage (EUS-BD) is an alternative treatment for biliary obstruction after failed endoscopic retrograde cholangiopancreatography (ERCP). In this study, we present the outcomes of inpatients with obstructive jaundice treated with EUS-BD using a fully covered metallic stent after failed ERCP. Patients and Methods. A total of 21 patients with biliary obstruction due to malignant tumors and prior unsuccessful ERCP underwent EUS via an intra- or extrahepatic approach with fully covered metallic stent between March 2014 and October 2015. A single endoscopist performed all procedures. Results. Seven patients underwent hepatogastrostomy (HGS) and 14 underwent choledochoduodenostomy (CDS). The technical and clinical success rates were both 100%. There was no difference in efficacy between HGS and CDS. Adverse events occurred in three patients, including two in the HGS group (1 bile leakage and 1 sepsis) and one in the CDS group (sepsis). Four patients died as a result of their primary tumors during a median follow-up period of 13 months (range: 3-21 months). No patient presented with stent migration. Conclusion. EUS-BD using a fully covered metallic stent appears to be a safe and effective method for the treatment of obstructive jaundice.
Shengjing Hospital of China Medical University, Shenyang 110004, China.
Jintao
J
Guo
Shengjing Hospital of China Medical University, Shenyang 110004, China.
Siyu
0000-0002-7308-0473
S
Sun
Shengjing Hospital of China Medical University, Shenyang 110004, China.
Xiang
0000-0003-3388-0940
X
Liu
Shengjing Hospital of China Medical University, Shenyang 110004, China.
Sheng
S
Wang
Shengjing Hospital of China Medical University, Shenyang 110004, China.
Nan
0000-0002-5764-7054
N
Ge
Shengjing Hospital of China Medical University, Shenyang 110004, China.
Guoxin
G
Wang