Prospective clinical study of endoscopic ultrasound-guided choledochoduodenostomy with direct metallic stent placement using a forward-viewing echoendoscope

K. Hara; K. Yamao; S. Hijioka; N. Mizuno; H. Imaoka; M. Tajika; S. Kondo; T. Tanaka; S. Haba; O. Takeshi; Y. Nagashio; T. Obayashi; A. Shinagawa; V. Bhatia; Y. Shimizu; H. Goto; Y. Niwa

doi:10.1055/s-0032-1326076

Endoscopy, Table of Contents

Endoscopy 2013; 45(05): 392-396
DOI: 10.1055/s-0032-1326076

Case report/series

Prospective clinical study of endoscopic ultrasound-guided choledochoduodenostomy with direct metallic stent placement using a forward-viewing echoendoscope

K. Hara

¹Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan

⁵Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan

,

K. Yamao

¹Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan

,

S. Hijioka

¹Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan

,

N. Mizuno

¹Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan

,

H. Imaoka

¹Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan

,

M. Tajika

²Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan

,

S. Kondo

²Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan

,

T. Tanaka

²Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan

,

S. Haba

¹Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan

,

O. Takeshi

¹Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan

,

Y. Nagashio

¹Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan

,

T. Obayashi

¹Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan

,

A. Shinagawa

¹Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan

,

V. Bhatia

³Department of Medical Hepatology, Institute of Liver and Biliary Sciences, Delhi, India

,

Y. Shimizu

⁴Department of Gastrointestinal Surgery, Aichi Cancer Center Hospital, Nagoya, Japan

,

H. Goto

⁵Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan

,

Y. Niwa

²Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan

› Author Affiliations

Abstract

A prospective clinical study was conducted to evaluate the safety, feasibility, and efficacy of endoscopic ultrasound (EUS)-guided choledochoduodenostomy (CDS) with direct metallic stent placement using a prototype forward-viewing echoendoscope. The indication for EUS – CDS in this study was lower biliary obstruction only, and not failed endoscopic biliary drainage, because the aim was to evaluate EUS – CDS for first-line biliary drainage therapy. The technical and functional success rates were 94 % (17 /18) and 94 % (16 /17), respectively. Early complications (focal peritonitis) were encountered in two patients (11 %). No patients developed late complications. EUS – CDS with direct metallic stent placement using a forward-viewing echoendoscope was generally feasible and effective for malignant distal biliary tract obstruction. The forward-viewing echoendoscope was useful, especially for deploying the metallic stent.

Full Text

References

References
1 Artifon EL, Okawa L, Takada J et al. EUS-guided choledochoantrostomy: an alternative for biliary drainage in unresectable pancreatic cancer with duodenal invasion. Gastrointest Endosc 2011; 73: 1317-1320
2 Itoi T, Yamao K. EUS 2008 Working Group document: evaluation of EUS-guided choledochoduodenostomy (with video). Gastrointest Endosc 2009; 69: 8-12
3 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
4 Siddiqui AA, Sreenarasimhaiah J, Lara LF et al. Endoscopic ultrasound-guided transduodenal placement of a fully covered metal stent for palliative biliary drainage in patients with malignant biliary obstruction. Surg Endosc 2011; 25: 549-555
5 Ramirez-Luna MA, Tellez-Avila FI, Giovannini M et al. Endoscopic ultrasound-guided biliodigestive drainage is a good alternative in patients with unresectable cancer. Endoscopy 2011; 43: 826-830
6 Hara K, Yamao K, Niwa Y et al. Prospective clinical study of EUS-guided choledochoduodenostomy for malignant lower biliary tract obstruction. Am J Gastroenterol 2011; 106: 1239-1245
7 Park do H, Koo JE, 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
8 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
9 Kida M, Araki M, Miyazawa S et al. Fine needle aspiration using forward-viewing endoscopic ultrasonography. Endoscopy 2011; 43: 796-801
10 Cotton PB, Eisen GM, Aabakken L et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc 2010; 71: 446-454
11 Giovannini M, Moutardier V, Pesenti C et al. Endoscopic ultrasound-guided bilioduodenal anastomosis: a new technique for biliary drainage. Endoscopy 2001; 33: 898-900
12 Burmester E, Niehaus J, Leineweber T et al. EUS-cholangio-drainage of the bile duct: report of 4 cases. Gastrointest Endosc 2003; 57: 246-251
13 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
14 Kahaleh M, Hernandez AJ, Tokar J et al. Interventional EUS-guided cholangiography: evaluation of a technique in evolution. Gastrointest Endosc 2006; 64: 52-59
15 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
16 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
17 Ang TL, Teo EK, Fock KM. 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 et al. 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 Brauer BC, Chen YK, Fukami N et al. Single-operator EUS-guided cholangiopancreatography for difficult pancreaticobiliary access (with video). Gastrointest Endosc 2009; 70: 471-479
22 Horaguchi J, Fujita N, Noda Y et al. Endosonography-guided biliary drainage in cases with difficult transpapillary endoscopic biliary drainage. Dig Endosc 2009; 21: 239-244
23 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: 75-78
24 Iwamuro M, Kawamoto H, Harada R et al. Combined duodenal stent placement and endoscopic ultrasonography-guided biliary drainage for malignant duodenal obstruction with biliary stricture. Dig Endosc 2010; 22: 236-240
25 Artifon EL, Takada J, Okawa L et al. EUS-guided choledochoduodenostomy for biliary drainage in unresectable pancreatic cancer: a case series. JOP 2010; 11: 597-600
26 Belletrutti PJ, Gerdes H, Schattner MA. Successful endoscopic ultrasound-guided transduodenal biliary drainage through a pre-existing duodenal stent. JOP 2010; 11: 234-236
27 Hara K, Yamao K, Niwa Y et al. Prospective clinical study of EUS-guided choledochoduodenostomy for malignant lower biliary tract obstruction. Am J Gastroenterol 2011; 106: 1239-1245
28 Siddiqui AA, Sreenarasimhaiah J, Lara LF et al. Endoscopic ultrasound-guided transduodenal placement of a fully covered metal stent for palliative biliary drainage in patients with malignant biliary obstruction. Surg Endosc 2011; 25: 549-555
29 Fabbri C, Luigiano C, Fuccio L et al. EUS-guided biliary drainage with placement of a new partially covered biliary stent for palliation of malignant biliary obstruction: a case series. Endoscopy 2011; 43: 438-441
30 Komaki T, Kitano M, Sakamoto H et al. Endoscopic ultrasonography-guided biliary drainage: evaluation of a choledochoduodenostomy technique. Pancreatology 2011; 11: 47-51
31 Prachayakul V, Aswakul P, Kachintorn U. EUS-guided choledochoduodenostomy for biliary drainage using tapered-tip plastic stent with multiple fangs. Endoscopy 2011; 43: E109-110
32 Ramirez-Luna MA, Téllez-Ávila FI, Giovannini M et al. Endoscopic ultrasound-guided biliodigestive drainage is a good alternative in patients with unresectable cancer. Endoscopy 2011; 43: 826-830
33 Park do H, Jang JW, Lee SS et al. EUS-guided biliary drainage with transluminal stenting after failed ERCP: predictors of adverse events and long-term results. Gastrointest Endosc 2011; 74: 1276-1284
34 Artifon EL, Aparicio D, Paione JB et al. Biliary drainage in patients with unresectable, malignant obstruction where ERCP fails: endoscopic ultrasonography-guided choledochoduodenostomy versus percutaneous drainage. J Clin Gastroenterol 2012; 46: 768-774
35 Attasaranya S, Netinasunton N, Jongboonyanuparp T et al. The spectrum of endoscopic ultrasound intervention in biliary diseases: a single center’s experience in 31 cases. Gastroenterol Res Pract 2012; 2012: 680753
36 Katanuma A, Maguchi H, Osanai M et al. Endoscopic ultrasound-guided biliary drainage performed for refractory bile duct stenosis due to chronic pancreatitis: a case report. Dig Endosc 2012; 24: 34-37
37 Kawakubo K, Isayama H, Nakai Y et al. Simultaneous duodenal metal stent placement and EUS-guided choledochoduodenostomy for unresectable pancreatic cancer. Gut Liver 2012; 6: 399-402
38 Khashab MA, Fujii LL, Baron TH et al. EUS-guided biliary drainage for patients with malignant biliary obstruction with an indwelling duodenal stent (with videos). Gastrointest Endosc 2012; 76: 209-213
39 Kim TH, Kim SH, Oh HJ et al. Endoscopic ultrasound-guided biliary drainage with placement of a fully covered metal stent for malignant biliary obstruction. World J Gastroenterol 2012; 18: 2526-2532
40 Song TJ, Hyun YS, Lee SS et al. Endoscopic ultrasound-guided choledochoduodenostomies with fully covered self-expandable metallic stents. World J Gastroenterol 2012; 18: 4435-4440