Multicenter retrospective study of endoscopic ultrasound-guided biliary drainage for malignant biliary obstruction in Japan

Kazumichi Kawakubo, Hiroyuki Isayama, Hironari Katou, Takao Itoi, Hiroshi Kawakami, Keiji Hanada, Hirotoshi Ishiwatari, Ichiro Yasuda, Hirofumi Kawamoto, Fumihide Itokawa, Masaki Kuwatani, Tomohiro Iiboshi, Tsuyoshi Hayashi, Shinpei Doi, Yousuke Nakai

Research output: Contribution to journalArticle

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Abstract

Background Endoscopic ultrasound-guided biliary drainage (EUS-BD) is considered to be an effective salvage procedure for failed endoscopic retrograde cholangiopancreatography in patients with unresectable malignant biliary obstruction. The aim of this retrospective study was to evaluate the efficacy and feasibility of EUS-BD. Methods From November 2006 to May 2012, a total of 64 patients who underwent EUS-BD (44 EUS-guided choledochoduodenostomy [EUS-CDS] and 20 EUS-guided hepaticogastrostomy [EUS-HGS]) at seven tertiary-care referral centers in Japan were included. The primary outcome was the technical success rate, and the secondary outcomes were the incidence of complications, stent dysfunction rate, time to stent dysfunction, and overall survival. Results The technical success rate for both EUS-CDS and EUS-HGS was 95%. The reasons for technical failure were two failed dilations of the anastomosis in EUS-CDS and one puncture failure in EUS-HGS. The stent dysfunction rate and 3-month dysfunction-free patency rate were 21% and 80% for EUS-CDS and 32% and 51% for EUS-HGS. There were 12 (six in EUS-CDS and six in EUS-HGS) procedure-related complications (19%): five cases of bile leakage (3/2), three stent misplacements (1/2), one pneumoperitoneum (1/0), two cases of bleeding (1/1), one perforation (1/0), and one biloma (0/1). Bile leakage was more frequently observed in patients who underwent plastic stent placement (11%) than in those with covered metal stents (4%). Conclusions This Japanese multicenter study revealed a high success rate in EUS-BD. However, the complication rate was as high as that in previous series. Covered metal stents may be useful to reduce bile leakage in EUS-BD.

Original languageEnglish
Pages (from-to)328-334
Number of pages7
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume21
Issue number5
DOIs
Publication statusPublished - 2014

Fingerprint

Choledochostomy
Multicenter Studies
Stents
Drainage
Japan
Retrospective Studies
Bile
Tertiary Care Centers
Metals
Pneumoperitoneum
Endoscopic Retrograde Cholangiopancreatography
Punctures
Dilatation
Hemorrhage
Survival
Incidence

Keywords

  • Biliary obstruction
  • Biliary stent
  • Endoscopic procedure
  • Endoscopic ultrasound-guided biliary drainage
  • Endoscopic ultrasound-guided procedure

ASJC Scopus subject areas

  • Hepatology
  • Surgery
  • Medicine(all)

Cite this

Multicenter retrospective study of endoscopic ultrasound-guided biliary drainage for malignant biliary obstruction in Japan. / Kawakubo, Kazumichi; Isayama, Hiroyuki; Katou, Hironari; Itoi, Takao; Kawakami, Hiroshi; Hanada, Keiji; Ishiwatari, Hirotoshi; Yasuda, Ichiro; Kawamoto, Hirofumi; Itokawa, Fumihide; Kuwatani, Masaki; Iiboshi, Tomohiro; Hayashi, Tsuyoshi; Doi, Shinpei; Nakai, Yousuke.

In: Journal of Hepato-Biliary-Pancreatic Sciences, Vol. 21, No. 5, 2014, p. 328-334.

Research output: Contribution to journalArticle

Kawakubo, K, Isayama, H, Katou, H, Itoi, T, Kawakami, H, Hanada, K, Ishiwatari, H, Yasuda, I, Kawamoto, H, Itokawa, F, Kuwatani, M, Iiboshi, T, Hayashi, T, Doi, S & Nakai, Y 2014, 'Multicenter retrospective study of endoscopic ultrasound-guided biliary drainage for malignant biliary obstruction in Japan', Journal of Hepato-Biliary-Pancreatic Sciences, vol. 21, no. 5, pp. 328-334. https://doi.org/10.1002/jhbp.27
Kawakubo, Kazumichi ; Isayama, Hiroyuki ; Katou, Hironari ; Itoi, Takao ; Kawakami, Hiroshi ; Hanada, Keiji ; Ishiwatari, Hirotoshi ; Yasuda, Ichiro ; Kawamoto, Hirofumi ; Itokawa, Fumihide ; Kuwatani, Masaki ; Iiboshi, Tomohiro ; Hayashi, Tsuyoshi ; Doi, Shinpei ; Nakai, Yousuke. / Multicenter retrospective study of endoscopic ultrasound-guided biliary drainage for malignant biliary obstruction in Japan. In: Journal of Hepato-Biliary-Pancreatic Sciences. 2014 ; Vol. 21, No. 5. pp. 328-334.
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abstract = "Background Endoscopic ultrasound-guided biliary drainage (EUS-BD) is considered to be an effective salvage procedure for failed endoscopic retrograde cholangiopancreatography in patients with unresectable malignant biliary obstruction. The aim of this retrospective study was to evaluate the efficacy and feasibility of EUS-BD. Methods From November 2006 to May 2012, a total of 64 patients who underwent EUS-BD (44 EUS-guided choledochoduodenostomy [EUS-CDS] and 20 EUS-guided hepaticogastrostomy [EUS-HGS]) at seven tertiary-care referral centers in Japan were included. The primary outcome was the technical success rate, and the secondary outcomes were the incidence of complications, stent dysfunction rate, time to stent dysfunction, and overall survival. Results The technical success rate for both EUS-CDS and EUS-HGS was 95{\%}. The reasons for technical failure were two failed dilations of the anastomosis in EUS-CDS and one puncture failure in EUS-HGS. The stent dysfunction rate and 3-month dysfunction-free patency rate were 21{\%} and 80{\%} for EUS-CDS and 32{\%} and 51{\%} for EUS-HGS. There were 12 (six in EUS-CDS and six in EUS-HGS) procedure-related complications (19{\%}): five cases of bile leakage (3/2), three stent misplacements (1/2), one pneumoperitoneum (1/0), two cases of bleeding (1/1), one perforation (1/0), and one biloma (0/1). Bile leakage was more frequently observed in patients who underwent plastic stent placement (11{\%}) than in those with covered metal stents (4{\%}). Conclusions This Japanese multicenter study revealed a high success rate in EUS-BD. However, the complication rate was as high as that in previous series. Covered metal stents may be useful to reduce bile leakage in EUS-BD.",
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author = "Kazumichi Kawakubo and Hiroyuki Isayama and Hironari Katou and Takao Itoi and Hiroshi Kawakami and Keiji Hanada and Hirotoshi Ishiwatari and Ichiro Yasuda and Hirofumi Kawamoto and Fumihide Itokawa and Masaki Kuwatani and Tomohiro Iiboshi and Tsuyoshi Hayashi and Shinpei Doi and Yousuke Nakai",
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T1 - Multicenter retrospective study of endoscopic ultrasound-guided biliary drainage for malignant biliary obstruction in Japan

AU - Kawakubo, Kazumichi

AU - Isayama, Hiroyuki

AU - Katou, Hironari

AU - Itoi, Takao

AU - Kawakami, Hiroshi

AU - Hanada, Keiji

AU - Ishiwatari, Hirotoshi

AU - Yasuda, Ichiro

AU - Kawamoto, Hirofumi

AU - Itokawa, Fumihide

AU - Kuwatani, Masaki

AU - Iiboshi, Tomohiro

AU - Hayashi, Tsuyoshi

AU - Doi, Shinpei

AU - Nakai, Yousuke

PY - 2014

Y1 - 2014

N2 - Background Endoscopic ultrasound-guided biliary drainage (EUS-BD) is considered to be an effective salvage procedure for failed endoscopic retrograde cholangiopancreatography in patients with unresectable malignant biliary obstruction. The aim of this retrospective study was to evaluate the efficacy and feasibility of EUS-BD. Methods From November 2006 to May 2012, a total of 64 patients who underwent EUS-BD (44 EUS-guided choledochoduodenostomy [EUS-CDS] and 20 EUS-guided hepaticogastrostomy [EUS-HGS]) at seven tertiary-care referral centers in Japan were included. The primary outcome was the technical success rate, and the secondary outcomes were the incidence of complications, stent dysfunction rate, time to stent dysfunction, and overall survival. Results The technical success rate for both EUS-CDS and EUS-HGS was 95%. The reasons for technical failure were two failed dilations of the anastomosis in EUS-CDS and one puncture failure in EUS-HGS. The stent dysfunction rate and 3-month dysfunction-free patency rate were 21% and 80% for EUS-CDS and 32% and 51% for EUS-HGS. There were 12 (six in EUS-CDS and six in EUS-HGS) procedure-related complications (19%): five cases of bile leakage (3/2), three stent misplacements (1/2), one pneumoperitoneum (1/0), two cases of bleeding (1/1), one perforation (1/0), and one biloma (0/1). Bile leakage was more frequently observed in patients who underwent plastic stent placement (11%) than in those with covered metal stents (4%). Conclusions This Japanese multicenter study revealed a high success rate in EUS-BD. However, the complication rate was as high as that in previous series. Covered metal stents may be useful to reduce bile leakage in EUS-BD.

AB - Background Endoscopic ultrasound-guided biliary drainage (EUS-BD) is considered to be an effective salvage procedure for failed endoscopic retrograde cholangiopancreatography in patients with unresectable malignant biliary obstruction. The aim of this retrospective study was to evaluate the efficacy and feasibility of EUS-BD. Methods From November 2006 to May 2012, a total of 64 patients who underwent EUS-BD (44 EUS-guided choledochoduodenostomy [EUS-CDS] and 20 EUS-guided hepaticogastrostomy [EUS-HGS]) at seven tertiary-care referral centers in Japan were included. The primary outcome was the technical success rate, and the secondary outcomes were the incidence of complications, stent dysfunction rate, time to stent dysfunction, and overall survival. Results The technical success rate for both EUS-CDS and EUS-HGS was 95%. The reasons for technical failure were two failed dilations of the anastomosis in EUS-CDS and one puncture failure in EUS-HGS. The stent dysfunction rate and 3-month dysfunction-free patency rate were 21% and 80% for EUS-CDS and 32% and 51% for EUS-HGS. There were 12 (six in EUS-CDS and six in EUS-HGS) procedure-related complications (19%): five cases of bile leakage (3/2), three stent misplacements (1/2), one pneumoperitoneum (1/0), two cases of bleeding (1/1), one perforation (1/0), and one biloma (0/1). Bile leakage was more frequently observed in patients who underwent plastic stent placement (11%) than in those with covered metal stents (4%). Conclusions This Japanese multicenter study revealed a high success rate in EUS-BD. However, the complication rate was as high as that in previous series. Covered metal stents may be useful to reduce bile leakage in EUS-BD.

KW - Biliary obstruction

KW - Biliary stent

KW - Endoscopic procedure

KW - Endoscopic ultrasound-guided biliary drainage

KW - Endoscopic ultrasound-guided procedure

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