Endoscopy 2021; 53(S 01): S41-S42
DOI: 10.1055/s-0041-1724356
Abstracts | ESGE Days
ESGE Days 2021 Oral presentations
Friday, 26 March 2021 10:00 – 10:45 Transduodenal EUS biliary approach: The best way? Room 6

Eus-Guided Choledochoduodenostomy Using a Lumen-Apposing Metal Stent for Malignant Distal Biliary Obstruction: a Retrospective Multicenter Analysis

A Fugazza
1   Humanitas Clinical and Research Center - IRCCS, Digestive Endoscopy Unit, Rozzano, Italy
,
C Fabbri
2   Forlì-Cesena Hospital, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena, Italy
,
R Di Mitri
3   ARNAS Civico Hospital, Gastroenterology and Endoscopy Unit, Palermo, Italy
,
MC Petrone
4   San Raffaele Scientific Institute - IRCCS, PancreatoBiliary Endoscopy and EUS Division, Milano, Italy
,
M Colombo
1   Humanitas Clinical and Research Center - IRCCS, Digestive Endoscopy Unit, Rozzano, Italy
,
M Ballarè
5   Maggiore della Carità Hospital, Department of Gastroenterology, Novara, Italy
,
L Cugia
6   Azienda Ospedaliero Universitaria Sassari, Gastroenterology and Digestive Endoscopy Department, Sassari, Italy
,
A Amato
7   Valduce Hospital, Department of Gastroenterology, Como, Italy
,
E Forti
8   Ospedale Ca’ Granda Niguarda, Digestive and Interventional Endoscopy Unit, Milano, Italy
,
G De Nucci
9   Guido Salvini Hospital, Department of Gastroenterology, Garbagnate Milanese, Italy
,
M Manno
10   Carpi Hospital, Gastroenterology and Digestive Endoscopy Unit, Carpi, Italy
,
V Pollino
11   Brotzu Hospital, Department of Endoscopic Surgery, Cagliari, Italy
,
C Binda
2   Forlì-Cesena Hospital, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena, Italy
,
R Macchiarelli
12   Policlinico S. Maria alle Scotte, Gastroenterology Unit, Siena, Italy
,
N Leone
13   Humanitas - Gradenigo, Digestive Endoscopy Unit, Torino, Italy
,
R Badas
14   University Hospital, Digestive Endoscopy Unit, Cagliari, Italy
,
M Lovera
15   Fondazione Poliambulanza Istituto Ospedaliero, Digestive Endoscopy Unit, Brescia, Italy
,
E Armellini
16   ASST Bergamo Est, Digestive Endoscopy Unit, Seriate, Italy
,
A Redaelli
17   San Gerardo Hospital, Gastroenterology and Endoscopy Unit, Monza, Italy
,
B Mangiavillano
18   Humanitas - Mater Domini, Gastrointestinal Endoscopy Unit, Castellanza, Italy
,
ML Brancaccio
19   S. Maria delle Croci Hospital, Division of Gastroenterology, Ravenna, Italy
,
F Attili
20   Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Digestive Endoscopy Unit, Roma, Italy
,
T Togliani
21   ASST Carlo Poma, Gastroenterology and Endoscopy Unit, Mantova, Italy
,
G Aragona
22   Guglielmo da Saliceto Hospital, Department of Internal Medicine, Piacenza, Italy
,
E Conte
3   ARNAS Civico Hospital, Gastroenterology and Endoscopy Unit, Palermo, Italy
,
M Maida
23   S. Elia-Raimondi Hospital, Gastroenterology and Endoscopy Unit, Caltanissetta, Italy
,
E Sinagra
24   Fondazione Istituto San Raffaele Giglio, Gastroenterology and Endoscopy Unit, Cefalù, Italy
,
A Repici
1   Humanitas Clinical and Research Center - IRCCS, Digestive Endoscopy Unit, Rozzano, Italy
,
I Tarantino
25   IRCCS-ISMETT, Endoscopy Service, Department of Diagnostic and Therapeutic Services, Palermo, Italy
,
A Anderloni
1   Humanitas Clinical and Research Center - IRCCS, Digestive Endoscopy Unit, Rozzano, Italy
› Author Affiliations
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    Aims Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) with lumen apposing metal stent (LAMS) has emerged as a procedure with encouraging results in terms of safety and effectiveness in patients with malignant distal biliary obstruction and failed endoscopic retrograde cholangiopancreatography (ERCP).

    Methods This is a multicenter, retrospective analysis including all cases of EUS-CDS with LAMS performed in patients with malignant distal biliary obstruction and failed ERCP in 23 Italian Centers from February 2015 to July 2020.

    Primary endpoints were technical and clinical success. Secondary endpoint was the adverse events (AEs) rate.

    Results A total of 256 patients (55.1 % males) with a mean age of 73.6 ± 12.4 were included in the study. The most common etiology of biliary stricture was pancreatic adenocarcinoma (75.4 %), followed by ampullary cancer (8.6 %) and cholangiocarcinoma (7.0 %). The common bile duct median diameter was 17.0 ± 4.0 mm. Technical and clinical success were achieved in 93.0 % and 89.5 % of cases respectively, with a mean bilirubin reduction at two weeks of 73 %. Median procedure time was 28.0 minutes. The mean follow-up was 148.1 days. Forty-nine AEs (13 mild, 28 moderate and 8 severe) occurred in 46 patients (18 %) and were classified as intraprocedural 21 (42.9 %), early < 15 days 10 (20.4 %), delayed > 15 days 18 (37.6 %). No fatal AE occurred.

    Conclusions The results of our study show that EUS-guided biliary drainage with LAMS in case of malignant distal biliary obstruction in patients with failed ERCP represents a viable alternative in terms of effectiveness, safety and long-term result with an acceptable adverse event rate. To the best of our knowledge this is the largest study in the literature concerning this procedure.

    Citation: Fugazza A, Fabbri C, Di Mitri R et al. OP97 EUS-GUIDED CHOLEDOCHODUODENOSTOMY USING A LUMEN-APPOSING METAL STENT FOR MALIGNANT DISTAL BILIARY OBSTRUCTION: A RETROSPECTIVE MULTICENTER ANALYSIS. Endoscopy 2021; 53: S41.


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    Publication History

    Article published online:
    19 March 2021

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