Japan Digestive Disease Week 2022
International Poster Session9 (JDDW)
October 28, 14:00–14:32, Room 15 (Marine Messe Fukuoka Arena Digital Poster Session)
IP-43_E
To create the neo-pappila using EUS-CDS fistula
- 1
- Department of Gastroenterology, Aichi Cancer Center Hospital
Background
Recently, we have managed EUS-CDS with the goal of stent-free by stent removal or some interventions. We will present the clinical results and recent management methods with the video.
Patients and Methods
Total 165 (malignant/benign 162/3) cases were performed EUS-CDS using FCSEMS for distal biliary obstruction between April 2003 and January 2022. These clinical data were retrospectively collected in database.
Results
Stent dislocation was occurred in 17.9% (29/165). 14 cases did not require re-intervention, and 5 cases needed balloon dilation, and finally 65.5% (19/29) cases became stent free. Stent removal was performed in 13.2% (18/136), and 61.1% (13/18) cases finally became stent free. 5 cases needed re-stenting due to tumor infiltration into fistula. Overall, in stent dislocation and removal cases with no tumor invasion surrounding CDS fistula, 76% (32/42)cases became stent free finally. Fistula patency of all cases was 247 days [10-1703].
Conclusions
EUS-CDS has the potential to be stent free and may create the “neo-papilla”. It is so useful for benign disease and malignant disease with a long prognosis because of no troubles cause by stents. It is necessary to develop a strategy for creating neo-papilla from now.
Recently, we have managed EUS-CDS with the goal of stent-free by stent removal or some interventions. We will present the clinical results and recent management methods with the video.
Patients and Methods
Total 165 (malignant/benign 162/3) cases were performed EUS-CDS using FCSEMS for distal biliary obstruction between April 2003 and January 2022. These clinical data were retrospectively collected in database.
Results
Stent dislocation was occurred in 17.9% (29/165). 14 cases did not require re-intervention, and 5 cases needed balloon dilation, and finally 65.5% (19/29) cases became stent free. Stent removal was performed in 13.2% (18/136), and 61.1% (13/18) cases finally became stent free. 5 cases needed re-stenting due to tumor infiltration into fistula. Overall, in stent dislocation and removal cases with no tumor invasion surrounding CDS fistula, 76% (32/42)cases became stent free finally. Fistula patency of all cases was 247 days [10-1703].
Conclusions
EUS-CDS has the potential to be stent free and may create the “neo-papilla”. It is so useful for benign disease and malignant disease with a long prognosis because of no troubles cause by stents. It is necessary to develop a strategy for creating neo-papilla from now.
- Index Term 1: EUS-CDS
- Index Term 2: EUS-BD