Format

Send to

Choose Destination
Endosc Ultrasound. 2019 Sep 25. doi: 10.4103/eus.eus_45_19. [Epub ahead of print]

Long-term outcomes of EUS-guided transluminal stent deployment for benign biliary disease: Multicenter clinical experience (with videos).

Author information

1
Therapeutic Endoscopic Ultrasound Group: TEUS; 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
2
Therapeutic Endoscopic Ultrasound Group: TEUS; Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan.
3
Therapeutic Endoscopic Ultrasound Group: TEUS; Department of Internal Medicine, Division of Gastroenterology, Graduate School of Medicine, Kobe University, Hyogo, Japan.
4
Therapeutic Endoscopic Ultrasound Group: TEUS; Department of Internal Medicine, Division of Gastroenterology and Hepatology, Tottori Red Cross Hospital, Tottori, Japan.
5
Therapeutic Endoscopic Ultrasound Group: TEUS; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
6
Therapeutic Endoscopic Ultrasound Group: TEUS; Department of Gastroenterology, Saku Central Hospital Advanced Care Center, Nagano, Japan.
7
Therapeutic Endoscopic Ultrasound Group: TEUS; Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
8
Therapeutic Endoscopic Ultrasound Group: TEUS; Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori, Japan.

Abstract

Background and Objectives:

Biliary drainage (BD) under EUS guidance is usually indicated for malignant biliary obstruction. Recently, EUS-guided transluminal treatment has been applied to benign biliary disease (BBD). This multicenter retrospective study evaluated the clinical impact of EUS-guided transluminal stent deployment for BBD with long-term follow-up.

Patients and Methods:

This retrospective study investigated patients treated between September 2015 and October 2016 at participating hospitals in the therapeutic endoscopic group. The inclusion criteria comprised complications with BBD obstructive jaundice or cholangitis and failed endoscopic retrograde cholangiopancreatography or inaccessible ampulla of Vater.

Results:

Twenty-six patients underwent EUS-guided transluminal stent deployment. Indications for EUS-guided transluminal stent deployment comprised anastomotic biliary stricture (n = 17), bile duct stones (n = 5), inflammatory biliary stricture (n = 3), and acute pancreatitis prevention (n = 1). Thirteen of these 26 patients underwent scheduled reintervention, with technical success achieved in all 13 patients. None of the deployed stents became dysfunctional. Among the 13 patients who underwent reintervention on demand, stents had become dysfunctional in six patients (stent patency: 48, 90, 172, 288, 289, and 608 days). Reintervention was successfully performed in all patients. During follow-up (median, 749 days), severe adverse events were not seen in any patients.

Conclusion:

We concluded that EUS-guided transluminal stent deployment for BBD is feasible and safe. Because metal stent dysfunction was more frequent when deployed on demand, such stents should be exchanged for plastic stents in a scheduled manner if a metal stent is used.

KEYWORDS:

Benign disease; EUS; EUS biliary drainage; EUS hepaticogastrostomy; EUS-guided biliary drainage

PMID:
31552912
DOI:
10.4103/eus.eus_45_19
Free full text

Supplemental Content

Full text links

Icon for Medknow Publications and Media Pvt Ltd
Loading ...
Support Center