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)) |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
outcomes_of_a_multicenter_registry_on_eus_guided.5.pdf | 212.54 kB | Adobe PDF | View/Open |
This item is licensed under a
Creative Commons License