Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/221894
Title: Outcomes of a multicenter registry on EUS-guided gallbladder drainage as a rescue technique for malignant distal biliary obstruction after failed endoscopic retrograde cholangiopancreatography
Author: Martínez Moreno, B.
López Roldán, Gonzalo
Escuer-Turu, Julia
Gornals Soler, Joan B.
Loras Alastruey, Carme
Gordo, Ana
Vila, Juan
Bazaga Pérez de Rozas, Sergio
Durá, Miguel
Sanchiz, Vicente
Zaragoza Velasco, Natividad
González Huix, Ferrán
Repiso Ortega, Alejandro
Aparicio Tormo, José Ramón
Keywords: Colangiopancreaticografia retrògrada endoscòpica
Malalties dels conductes biliars
Endoscopic retrograde cholangiopancreatograph
Bile ducts diseases
Issue Date: 5-May-2025
Publisher: Ovid Technologies (Wolters Kluwer Health)
Abstract: Background and Objectives: Endoscopic retrograde cholangiopancreatography (ERCP) is the primary intervention for malignant distal biliary obstruction (MDBO). However, ERCP may fail for various reasons, requiring alternative interventions such as EUS-guided biliary drainage. Among EUS-guided biliary drainage (EUS-BD) methods, EUS-guided gallbladder drainage (EUS-GBD) is emerging as a viable option for patients who have failed ERCP and EUS-BD. The aim of this study is to evaluate the efficacy and safety of EUS-GBD as salvage therapy for MDBO and its potential role in allowing the initiation of chemotherapy. Methods: This is a retrospective multicenter study of consecutive patients with MDBO with failed ERCP and/or EUS-BD that subsequently underwent EUS-GBD with lumen-apposing metal stent. Results: Ninety-six patients from 9 centers in Spain were included. Technical success was achieved in 99% of patients, while clinical success, defined as bilirubin reduction <50% within 14 days after the procedure, was achieved in 78.1% of patients. Bilirubin levels were normalized in 65.6% of patients. The median time to normalization of bilirubin levels was 15 (7-27) days. Related to continuation of oncological treatment, 44/77 (57.1%) eligible patients were able to start chemotherapy after the procedure, and 12/17 (70.6%) eligible patients underwent surgery in the end. Adverse events were observed in 26.3% of cases, with 3 patients requiring surgery and 3 deaths related to EUS-GBD. Conclusions: EUS-GBD represents a potential alternative to MDBO in cases where ERCP has failed, with an appropriate profile of patients starting chemotherapy. However, in light of the considerable number of adverse events and the moderate efficacy, it may be advisable to consider this approach as a second-line option.
Note: Reproducció del document publicat a: https://doi.org/10.1097/eus.0000000000000116
It is part of: Endoscopic Ultrasound, 2025, vol. 14, num. 2, p. 73-78
URI: https://hdl.handle.net/2445/221894
Related resource: https://doi.org/10.1097/eus.0000000000000116
ISSN: 2303-9027
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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