Endoscopy 2020; 52(S 01): S305-S306
DOI: 10.1055/s-0040-1704979
ESGE Days 2020 ePoster presentations
Thursday, April 23, 2020 09:00 – 17:00 Endoscopic ultrasound ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

CONCOMITANT MALIGNANT DUODENAL AND BILIARY STENOSIS: DUODENAL STENTING AND HEPATICOGASTROSTOMY DURING THE SAME PROCEDURE IS A SAFETY PROCEDURE (SAMETIME STUDY)

A Debourdeau
1   Montpellier University Hospital, Montpellier, France
2   Paoli-Calmettes Institute, Marseille, France
,
F Caillol
3   UEMCO, Paoli-Calmettes Institute, Marseille, France
,
JP Ratone
2   Paoli-Calmettes Institute, Marseille, France
,
J Winkler
2   Paoli-Calmettes Institute, Marseille, France
,
C Decoster
2   Paoli-Calmettes Institute, Marseille, France
,
C Pesenti
2   Paoli-Calmettes Institute, Marseille, France
,
E Bories
2   Paoli-Calmettes Institute, Marseille, France
,
M Giovannini
2   Paoli-Calmettes Institute, Marseille, France
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available at
 

Aims The concomitant biliary and duodenal malignant stenosis is a rare event, reflecting a locally advanced neoplastic process. We conducted a retrospective study to evaluate biliary drainage in association with duodenal stenting.

Methods Patients were included from 01.01.2011 to 31.12.2017. Patients included had palliative endoscopic management with biliary drainage and duodenal stenting in the same time or within 7 days or less for concomitant bilio-duodenal malignant stenosis.

The primary endpoint was the length of hospitalization required for double drainage. Secondary endpoints were biliary and duodenal reintervention rate, significant postoperative adverse events rate (Dindo-Clavien classification ≥ III), and overall survival.

Patients were divided into several groups for statistical analysis.

SAMETIME drainage group if the two procedures were done on the same day VS DEFFERED drainage group if the two procedures were done in different days (< 7 days).

And secondly, EUS-hepaticogastrostomy VS DUODENALACCESS if the drainage was done by ERCP, radiological or choledoduodenostomy.

Results 31 patients were included (19 women, mean age = 66).

Stenosis was related to pancreatic cancer in most of cases 17 patients (54%).

16(52%) patients were in the SAMETIME group, 15(48%) in the DEFFERED group.

11 patients(35%) had EUS-HG and 20(65%) had DUODENALACCESS: PCTBD for 11 (35%) patients,ERCP for 8 patients(26%) and choledoduodenostomy for 1.

Median survival was 76 days.

Patients in the group SAMETIME had significantly shorter hospitalization than the DEFFERED group: 7.47 days vs 12,5 days (p = 0.035).

SAMETIME group trended to have a lower rate of postoperative complications (27% VS 56%; p = 0.0953).

EUS-HG group trended to have lower rate of postoperative complications (18% VS 55% p = 0.065) and less biliary endoscopic revision (9% VS 30% p = 0.37).

Conclusions SAMETIME drainage is associated with a halved hospitalization time and probably with less adverse events than a two procedures drainage. EUS-HG should be preferred because of no more complication and a tendancy to better patency.