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DOI: 10.1055/s-0030-1256406
© Georg Thieme Verlag KG Stuttgart · New York
Endoscopic ultrasound-guided biliodigestive drainage is a good alternative in patients with unresectable cancer
Publication History
submitted 26 October 2010
accepted after revision 4 March 2011
Publication Date:
10 August 2011 (online)
A total of 11 prospective cases of endoscopic ultrasound (EUS)-guided cholangio-drainage (EUCD) in patients with end-stage biliopancreatic cancer and biliary tract obstruction are reported. Other available drainage methods (endoscopic retrograde cholangiopancreatography and/or percutaneous transhepatic biliary drainage) of the biliary tract were attempted without success prior to EUS. Technical and clinical success was achieved in 10/11 patients (91 %) and in 9/10 patients (90 %), respectively. Bilirubin decreased by more than 50 % in 7/11 patients (64 %). One patient had a complication that required re-intervention and another patient developed biloma. No mortality directly related to the procedure was documented. In conclusion, EUCD is a good alternative for patients with malignant obstruction of the biliary tract in whom other drainage methods have failed.
References
- 1 Itoi T, Yamao K. EUS 2008 Working Group document: evaluation of EUS-guided choledochoduodenostomy. Gastrointest Endosc. 2009; 69 S8-S12
- 2 Savides T, Varadaajulu S, Palazzo L. EUS 2008 Working Group document: evaluation of EUS-guided hepaticogastrostomy. Gastrointest Endosc. 2009; 69 S3-S7
- 3 Levy M. Therapeutic endoscopic ultrasound for biliary and pancreatic disorders. Curr Gastroenterol Rep. 2010; 12 141-149
- 4 Wiersema M J, Sandusky D, Carr R et al. Endosonography-guided cholangiopancreatography. Gastrointest Endosc. 1996; 43 102-106
- 5 Giovannini M, Moutardier V, Pesenti C et al. Endoscopic ultrasound-guided bilioduodenal anastomosis: a new technique for biliary drainage. Endoscopy. 2001; 33 898-900
- 6 Burmester E, Niehaus J, Leineweber T et al. EUS-cholangiodrainage of the bile duct: Report of 4 cases. Gastrointest Endosc. 2003; 57 246-251
- 7 Kahaleh M, Yoshida C, Kane L, Yeaton P. Interventional EUS cholangiography: a report of five cases. Gastrointest Endosc. 2004; 60 138-142
- 8 Kahaleh M, Hernandez A J, Tokar J et al. Interventional EUS-guided cholangiography: evaluation of a technique in evolution. Gastrointest Endosc. 2006; 64 52-59
- 9 Kahaleh M, Wang P, Shami V M et al. EUS-guided transhepatic cholangiography: report of 6 cases. Gastrointest Endosc. 2005; 61 307-313
- 10 Bories E, Pesenti C, Caillol F et al. Transgastric endoscopic ultrasonography-guided biliary drainage: results of a pilot study. Endoscopy. 2007; 39 287-291
- 11 Maranki J, Hernandez A J, Arslan B et al. Interventional endoscopic ultrasound-guided cholangiography: long-term experience of an emerging alternative to percutaneous transhepatic cholangiography. Endoscopy. 2009; 41 532-538
- 12 Puspok A, Lomoschitz F, Dejaco C et al. Endoscopic ultrasound guided therapy of benign and malignant biliary obstruction: a case series. Am J Gastroenterol. 2005; 100 1743-1747
- 13 Will U, Thieme A, Fueldner F et al. Treatment of biliary obstruction in selected patients by endoscopic ultrasonography (EUS)-guided transluminal biliary drainage. Endoscopy. 2007; 39 292-295
- 14 Yamao K, Bhatia V, Mizuno N et al. EUS-guided choledochoduodenostomy for palliative biliary drainage in patients with malignant biliary obstruction: results of long-term follow-up. Endoscopy. 2008; 40 340-342
- 15 Brauer B C, Chen Y K, Fukami N, Shah R J. Single-operator EUS-guided cholangiopancreatography for difficult pancreaticobiliary access (with video). Gastrointest Endosc. 2009; 70 471-479
- 16 Yamao K, Sawaki A, Takahashi K et al. EUS-guided choledochoduodenostomy for palliative biliary drainage in case of papillary obstruction: report of 2 cases. Gastrointest Endosc. 2006; 64 663-667
- 17 Ang T L, Teo E K, Fock K M. EUS-guided transduodenal biliary drainage in unresectable pancreatic cancer with obstructive jaundice. JOP. 2007; 8 438-443
- 18 Fujita N, Noda Y, Kobayashi G et al. Histological changes at an endosonography-guided biliary drainage site: a case report. World J Gastroenterol. 2007; 13 5512-5515
- 19 Tarantino I, Barresi L, Repici A, Traina M. EUS-guided biliary drainage: a case series. Endoscopy. 2008; 40 336-339
- 20 Itoi T, Itokawa F, Sofuni A et al. Endoscopic ultrasound-guided choledochoduodenostomy in patients with failed endoscopic retrograde cholangiopancreatography. World J Gastroenterol. 2008; 14 6078-6082
- 21 Hanada K, Iiboshi T, Ishii Y. Endoscopic ultrasound-guided choledochoduodenostomy for palliative biliary drainage in cases with inoperable pancreas head carcinoma. Dig Endosc. 2009; 21 (Suppl. 1) S75-S78
- 22 Park do H, Koo J E, Oh J et al. EUS-guided biliary drainage with one-step placement of a fully covered metal stent for malignant biliary obstruction: a prospective feasibility study. Am J Gastroenterol. 2009; 104 2168-2174
- 23 Artifon E L, Chaves D M, Ishioka S et al. Echoguided hepatico-gastrostomy: a case report. Clinics (Sao Paulo). 2007; 62 799-802
M. A. Ramírez-LunaMD
Endoscopy Department
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Vasco de Quiroga #15
Col. Sección XVI Del. Tlalpan
C.P. 14000
Mexico City
Mexico
Fax: +52-55-4870900
Email: mangelramirez@yahoo.com