Endoscopic Retrograde Cholangiopancreatography-guided Biliary Drainage with Duckbill-type Anti-reflux Metal Stent versus Endoscopic Ultrasound-guided Hepaticogastrostomy for Malignant Distal Biliary Obstruction in Pancreatic Cancer with Duodenal Invasion
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View abstract on PubMed
Summary
This summary is machine-generated.Transpapillary biliary drainage with anti-reflux metal stents (ARMS) and endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) showed comparable outcomes for managing malignant distal biliary obstruction (MDBO) in patients with duodenal invasion. D-ARMS is a viable option, particularly in non-high-volume centers.
Area Of Science
- Gastroenterology
- Interventional Endoscopy
- Oncology
Background
- Duodenal invasion in pancreatic cancer increases the risk of recurrent biliary obstruction (RBO) due to duodenobiliary reflux.
- Transpapillary biliary drainage with anti-reflux metal stents (ARMS) and endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) are key management strategies.
Purpose Of The Study
- To compare the efficacy and safety of duckbill-type ARMS (D-ARMS) versus EUS-HGS in managing malignant distal biliary obstruction (MDBO) in patients with duodenal invasion.
Main Methods
- Retrospective review of unresectable pancreatic cancer patients with duodenal invasion undergoing D-ARMS or EUS-HGS.
- Comparison of technical/clinical success, RBO causes, adverse events (AEs), time to RBO (TRBO), and endoscopic reintervention (ERI).
Main Results
- No significant differences in technical/clinical success rates between D-ARMS (n=22) and EUS-HGS (n=22).
- Non-RBO AE rates were 9.1% for D-ARMS vs. 36.4% for EUS-HGS (p=0.069).
- Overall RBO rates, median TRBO, and ERI outcomes were comparable between groups.
Conclusions
- Transpapillary biliary drainage using D-ARMS is a viable option for MDBO with duodenal invasion.
- D-ARMS may be particularly suitable for non-high-volume centers when technically feasible.
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