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. 2021 Sep 11;10(18):4105.
doi: 10.3390/jcm10184105.

Outcomes of Endoscopic Ultrasound-Guided Biliary Drainage in a General Hospital for Patients with Endoscopic Retrograde Cholangiopancreatography-Difficult Transpapillary Biliary Drainage

Naosuke Kuraoka  1 , Satoru Hashimoto  1 , Shigeru Matsui  1 , Shuji Terai  2
Affiliations

Outcomes of Endoscopic Ultrasound-Guided Biliary Drainage in a General Hospital for Patients with Endoscopic Retrograde Cholangiopancreatography-Difficult Transpapillary Biliary Drainage

Naosuke Kuraoka et al. J Clin Med. .

Abstract

Endoscopic ultrasound-guided biliary drainage (EUS-BD) has been developed as an alternative treatment for percutaneous transhepatic biliary drainage for patients with bile duct stenosis. At specialized hospitals, the high success rate and effectiveness of EUS-BD as primary drainage has been reported. However, the procedure is highly technical and difficult, and it has not been generally performed. In this study, we retrospectively examined the effectiveness of EUS-BD in ERCP-difficult patients with distal bile duct stenosis. We retrospectively examined 24 consecutive cases in which EUS-BD was performed at our hospital for distal bile duct stenosis from October 2018 to December 2020. EUS-guided choledochoduodenostomy (EUS-CDS) was selected for cases that could be approached from the duodenal bulb, and EUS-HGS was selected for other cases. In the EUS-CDS and EUS-HGS groups, the technical success rates were 83.3% (10/12] and 91.7% (11/12], respectively. An adverse event occurred in one case in the EUS-CDS group, which developed severe biliary peritonitis. The stent patency period was 91 and 101 days in the EUS-CDS and EUS-HGS groups, respectively. EUS-BD for ERCP-difficult patients with distal bile duct stenosis is considered to be an effective alternative for biliary drainage that can be performed not only in specialized hospitals but also in general hospitals.

Keywords: ERCP; EUS-BD; EUS-CDS; EUS-HGS; biliary stenosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Procedure of endoscopic ultrasound-guided choledochoduodenostomy.
Figure 2
Figure 2
Procedure of endoscopic ultrasound-guided hepaticogastrostomy.
Figure 3
Figure 3
Stent patency of EUS-CDS and EUS-HGS. The stent patency period is 91 days in the EUS-CDS group and 101 days in the EUS-HGS group. EUS-CDS: endoscopic ultrasound-guided choledochoduodenostomy, EUS-HGS: endoscopic ultrasound-guided hepaticogastrostomy.
See this image and copyright information in PMC

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