Endoscopic Ultrasound-Guided Biliary Drainage Using a Fully Covered Metallic Stent after Failed Endoscopic Retrograde Cholangiopancreatography

الملخص EN

Background and Study Aims.

Endoscopic ultrasound- (EUS-) guided biliary drainage (EUS-BD) is an alternative treatment for biliary obstruction after failed endoscopic retrograde cholangiopancreatography (ERCP).

In this study, we present the outcomes of inpatients with obstructive jaundice treated with EUS-BD using a fully covered metallic stent after failed ERCP.

Patients and Methods.

A total of 21 patients with biliary obstruction due to malignant tumors and prior unsuccessful ERCP underwent EUS via an intra- or extrahepatic approach with fully covered metallic stent between March 2014 and October 2015.

A single endoscopist performed all procedures.

Results.

Seven patients underwent hepatogastrostomy (HGS) and 14 underwent choledochoduodenostomy (CDS).

The technical and clinical success rates were both 100%.

There was no difference in efficacy between HGS and CDS.

Adverse events occurred in three patients, including two in the HGS group (1 bile leakage and 1 sepsis) and one in the CDS group (sepsis).

Four patients died as a result of their primary tumors during a median follow-up period of 13 months (range: 3–21 months).

No patient presented with stent migration.

Conclusion.

EUS-BD using a fully covered metallic stent appears to be a safe and effective method for the treatment of obstructive jaundice.