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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
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EUS-Guided Bile Duct Drainage (EUBD) in 95 Patients
U Will1, F Fueldner1, C Kern1
1Dept. of Gastroenterology, Municipal Hospital (Waldklinikum Gera gGmbH), Gera, Germany.
Ultraschall in Der Medizin (Stuttgart, Germany : 1980)
|May 24, 2014
Summary
Endoscopic ultrasound-guided transluminal biliary drainage (EUBD) offers a promising alternative for treating biliary obstruction when standard ERCP fails. This technique demonstrates feasibility and long-term efficacy, particularly for malignant conditions, potentially avoiding percutaneous drainage.
Area of Science:
- Gastroenterology
- Interventional Endoscopy
- Biliary Interventions
Background:
- Endoscopic retrograde cholangiopancreatography (ERCP) with stenting is the standard for biliary obstruction.
- Alternative drainage methods like percutaneous transhepatic cholangiography (PTCD) or surgery are used when ERCP fails.
- EUS-guided transluminal biliary drainage (EUBD) presents a potential minimally invasive alternative.
Purpose of the Study:
- To evaluate the feasibility and long-term outcomes of EUS-guided transluminal biliary drainage (EUBD).
- To assess EUBD as an alternative to percutaneous or surgical drainage in complex biliary obstruction cases.
Main Methods:
- A prospective, single-center database of patients undergoing EUBD over a 10-year period was analyzed.
- Feasibility was assessed by technical and clinical success rates, including long-term follow-up.
- Data included cholangiography success, drainage intention, and etiology of obstruction.
Main Results:
- EUBD achieved a high cholangiography success rate (97.9%).
- Drainage was performed in 86.9% of patients, with a complication rate of 15.7% (1.1% mortality).
- Long-term follow-up (3-60 months) showed a low reintervention rate.
Conclusions:
- EUS-guided transluminal biliary drainage (EUBD) is a feasible and promising therapy for biliary obstruction, especially in malignant cases.
- EUBD provides an effective internal drainage option, potentially preventing the need for percutaneous drainage (PTCD).
- This advanced technique requires significant interventional expertise and is best performed in specialized tertiary centers.
