| International Session (Workshop) 2 (JGES・JSGE・JSGS) |
| Sat. November 3rd 14:40 - 17:00 Room 13: Kobe International Conference Center International Conference Room |
| Clinical outcomes of endoscopic ultrasound-guided biliary drainage for unresectable malignant biliary obstruction when ERCP fails | |||
| Yoshihide Kanno1, Kei Ito1, Shinsuke Koshita1 | |||
| 1Sendai City Medical Center | |||
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| Aim: To evaluate clinical outcomes of endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) for unresectable malignant biliary obstruction for cases in which endoscopic retrograde cholangiopancreatography (ERCP) failed at a high-volume center where ERCP is strictly prioritized over EUS-BD. Methods: All 111 EUS-BD cases of unresectable malignant biliary obstruction between February 2007 and March 2018 were retrospectively evaluated. Technical success, clinical success, adverse events, and time to recurrence of biliary obstruction were evaluated. Results: EUS-BD was technically successful in 98% of the patients (109/111). The clinical success rate was 93% (101/109). Adverse events that were definitely related to the procedure were observed in 11 patients (10%; peritonitis in 6, acute cholecystitis in 4, ARDS in 1). Three patients with a poor performance status succumbed shortly after the successful EUS-BD, with a possible association between the procedure and death. In the 87 patients with a bilioenteric stent, median time to recurrence of biliary obstruction determined using the Kaplan-Meier method was 385 days (95% confidence interval [CI], 50-720 days) during the mean follow-up period of 106 +/- 135 days. Conclusions: EUS-BD was found to be feasible. However, there were a few patients with an unfavorable course after successful EUS-BD. |
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Index Term 1: EUS-guided biliary drainage Index Term 2: Malignant biliary obstruction |
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