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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(02): E262-E268
DOI: 10.1055/a-2261-3137
Original article

Evaluation of exclusive internal endoscopic drainage for complex biloma with transluminal and transpapillary stenting

Jun Sakamoto
1   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki-shi, Japan (Ringgold ID: RIN13010)
,
Takeshi Ogura
2   2nd Department of Internal Medicine, Osaka Medical College, Takatsuki-shi, Japan
,
Saori Ueno
2   2nd Department of Internal Medicine, Osaka Medical College, Takatsuki-shi, Japan
,
Atsushi Okuda 
2   2nd Department of Internal Medicine, Osaka Medical College, Takatsuki-shi, Japan
,
Nobu Nishioka
2   2nd Department of Internal Medicine, Osaka Medical College, Takatsuki-shi, Japan
,
Akitoshi Hakoda 
2   2nd Department of Internal Medicine, Osaka Medical College, Takatsuki-shi, Japan
,
Yuki Uba
1   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki-shi, Japan (Ringgold ID: RIN13010)
,
Mitsuki Tomita
1   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki-shi, Japan (Ringgold ID: RIN13010)
,
Nobuhiro Hattori
2   2nd Department of Internal Medicine, Osaka Medical College, Takatsuki-shi, Japan
,
Junichi Nakamura
1   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki-shi, Japan (Ringgold ID: RIN13010)
,
Kimi Bessho
1   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki-shi, Japan (Ringgold ID: RIN13010)
,
Hiroki Nishikawa
1   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki-shi, Japan (Ringgold ID: RIN13010)
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Abstract

Background and study aims Biloma is treated endoscopically with endoscopic retrograde cholangiography (ERCP) or endoscopi ultrasound-guided transluminal biloma drainage (EUS-TBD). However, almost all previous studies have used both internal and external drainage. External drainage has the disadvantages of poor cosmetic appearance and self-tube removal. The aim of the present study was to evaluate the internal endoscopic drainage for complex biloma after hepatobiliary surgery with an ERCP- or EUS-guided approach, without external drainage.

Patients and methods This retrospective study included consecutive patients who had bilomas. A 7F plastic stent was deployed from the biloma to the duodenum in the ERCP group and the metal stent was deployed from the biloma to the stomach in the EUS-TBD group.

Results Forty-seven patients were enrolled. The technical success rate was similar between the groups (ERCP 94% vs EUS-TBD 100%, P=0.371); however, mean procedure time was significantly shorter in the EUS-TBD group (16.9 minutes) than in the ERCP group (26.6 minutes) (P=0.009). The clinical success rate was 87% (25 of 32 patients) in the ERCP group and 84% (11 of 13 patients) in the EUS-TBD group (P=0.482). The duration of median hospital stay was significantly shorter in the EUS-TBD group (22 days) than in the ERCP group (46 days) (P=0.038). There was no significant difference in procedure-associated adverse events between the groups.

Conclusions In conclusion, ERCP and EUS-TBD are complementary techniques, each with its own merits in specific clinical scenarios. If both techniques can be performed, EUS-TBD should be considered because of the short times for the procedure, hospital stay. and biloma resolution.

Keywords

Pancreatobiliary (ERCP/PTCD) - Endoscopic ultrasonography - Intervention EUS


Publikationsverlauf

Eingereicht: 04. Dezember 2023

Angenommen nach Revision: 01. Februar 2024

Accepted Manuscript online:
05. Februar 2024

Artikel online veröffentlicht:
28. Februar 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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