TY - JOUR
T1 - Long-term outcomes of EUS-guided transluminal stent deployment for benign biliary disease
T2 - Multicenter clinical experience (with videos)
AU - Ogura, Takeshi
AU - Takenaka, Mamoru
AU - Shiomi, Hideyuki
AU - Goto, Daisuke
AU - Tamura, Takashi
AU - Hisa, Takeshi
AU - Kato, Hironari
AU - Nishioka, Nobu
AU - Minaga, Kosuke
AU - Masuda, Atsuhiro
AU - Onoyama, Takumi
AU - Kudo, Masatoshi
AU - Higuchi, Kazuhide
AU - Kitano, Masayuki
N1 - Funding Information:
The present study was supported by grants from the Japan Society for the Promotion of Science.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - 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.
AB - 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.
KW - Benign disease
KW - EUS
KW - EUS biliary drainage
KW - EUS hepaticogastrostomy
KW - EUS-guided biliary drainage
UR - http://www.scopus.com/inward/record.url?scp=85077253496&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85077253496&partnerID=8YFLogxK
U2 - 10.4103/eus.eus_45_19
DO - 10.4103/eus.eus_45_19
M3 - Article
AN - SCOPUS:85077253496
VL - 8
SP - 398
EP - 403
JO - Endoscopic Ultrasound
JF - Endoscopic Ultrasound
SN - 2303-9027
IS - 6
ER -