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Updated: May 6, 2026
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Single-phase percutaneous recanalization of malignant bile duct obstructions with a covered stent graft
F Scheer1, C Wissgott1, C W Lüdtke1
1Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide.
Purpose:
The aim of this study was to evaluate the benefit of a percutaneous transhepatic biliary drainage (PTCD) endoprothesis in the case of patients with malignant occlusion of the common bile duct (CBD).
Materials And Methods:
32 patients (mean age 72 ± 13 years) were treated with an endoprosthesis (VIABIL; M. L. GORE & ASSOCIATES, INC., USA) due to failed attempts of endoscopic retrograde cholangiopancreatography (ERCP) in the case of malignant occlusion of the CBD.
Results:
The technical success rate was 96.9 %. In one patient the probing of an intrahepatic bile duct was impossible. Two major complications (bleeding, liver abscess) were successfully treated with appropriate measures. The bilirubin level did not significantly decrease immediately after intervention (13.2 ± 6.5 mg/dl; p > 0.05). However, the follow-up displayed a highly significant decrease of bilirubin to 6.0 ± 7.4 mg/dl; p < 0.05). The endoprosthesis was extended with bare metal NITINOL stents in 9 patients. The mean survival time of the patient group was 64 ± 28 days (range 2 - 250 days).
Conclusion:
The implantation of an endoprosthesis proved to be an option with high technical success, a low complication rate and good benefit in our patients with malignant bile duct obstruction in palliative therapy situations.
Key Points:
• The primary objective in the case of malignant bile duct obstruction is the treatment of jaundice.• After failed endoscopic recanalization of the bile ducts, transhepatic biliary drainage is desirable.• An ePTFE-FEP covered endoprothesis is a good treatment option in palliative situations.• A single-stage procedure shortens hospitalization time.
