期刊
GASTROINTESTINAL ENDOSCOPY
卷 84, 期 6, 页码 941-946出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.gie.2016.05.035
关键词
-
资金
- Boston Scientific
- Fujinon
- Pentax
- MI Tech
- EMcison
- Xlumena Inc.
- W.L. Gore
- MaunaKea
- Apollo Endosurgery
- Cook Endoscopy
- ASPIRE Bariatrics
- GI Dynamics
- NinePoint Medical
- Merit Medical
- Olympus
Background and Aims: EUS-guided biliary drainage (EUS-BD) has been offered for more than a decade as an alternative to percutaneous biliary drainage. Multiple approaches have been described. We propose an algorithm for biliary drainage based on patient anatomy. We aim to assess its validity and safety to guide EUS-BD drainage. Methods: All patients with biliary obstruction who underwent EUS-BD after failed ERCP from July 2011 through November 2015 underwent the drainage procedure according to the novel algorithm and were enrolled in a dedicated prospective registry. Patients with a dilated intrahepatic biliary tree (IHBT) on cross-sectional imaging received an intrahepatic (IH) approach with anterograde biliary stent placement or hepaticogastrostomy stent placement if anterograde placement was not feasible. Patients with a nondilated IHBT on cross-sectional imaging underwent an extrahepatic (EH) approach with a rendezvous (RDV) technique or a transenteric stent placement if the RDV technique was not feasible. If IH drainage was attempted but unsuccessful, conversion to an EH approach was performed. Results: Fifty-two patients (mean age, 68 +/- 12 years; 52% men) were included in the registry. Technical success was achieved in 50 patients (96%). Twenty-seven of 52 patients (52%) underwent IH anterograde stent placement, 8 of 52 (15%) underwent hepaticogastrostomy, 11 of 52 (21%) underwent EH drainage with the RDV technique, and 6 of 52 (12%) underwent EH drainage with transenteric stent placement. Adverse events were observed in 5 patients (10%) and included a liver abscess requiring percutaneous drainage (n = 1) and bleeding (n = 4) with 1 postprocedural death secondary to bleeding. Conclusions: EUS-BD obstruction after failed conventional ERCP is successful and safe when this novel algorithm is used.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据