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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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A multi-institution consensus on how to perform EUS-guided biliary drainage for malignant biliary obstruction
Jintao Guo1, Marc Giovannini2, Anand V Sahai3
1Endoscopy Center, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China.
Endoscopic Ultrasound
|December 12, 2018
Summary
Endoscopic ultrasound-guided biliary drainage (EUS-BD) is useful for malignant biliary obstruction (MBO). This global survey reveals varied EUS-BD practices, highlighting the need for standardized approaches and further research.
Area of Science:
- Gastroenterology
- Interventional Endoscopy
- Oncology
Background:
- EUS-guided biliary drainage (EUS-BD) is a valuable tool for managing malignant biliary obstruction (MBO).
- Current practices and consensus on EUS-BD techniques are not well-established globally.
Purpose of the Study:
- To survey international EUS practitioners on their current practices for EUS-guided biliary drainage in malignant biliary obstruction.
- To identify variations and potential areas for standardization in EUS-BD procedures.
Main Methods:
- A worldwide, multi-institutional survey was conducted among members of the International Society of EUS.
- The survey comprised 10 questions focusing on the practical aspects of performing EUS-BD.
Main Results:
- Forty-six endoscopists completed the survey, indicating a preference for EUS-BD over percutaneous transhepatic biliary drainage after ERCP failure.
- The rendezvous stenting technique was favored as the primary method, with self-expandable metal stents (SEMSs) recommended.
- Variations exist in stent type and length recommendations for different EUS-BD approaches (HGS, choledochoduodenostomy, IH).
Conclusions:
- This is the first global survey detailing EUS-BD practices for MBO.
- Significant practice variations necessitate randomized controlled trials to establish optimal EUS-BD strategies.
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