Conversion of percutaneous transhepatic biliary drainage to endoscopic ultrasound-guided biliary drainage.
adverse event
endoscopic ultrasound‐guided biliary drainage
malignant biliary obstruction
percutaneous transhepatic biliary drainage
recurrent biliary obstruction
re‐intervention
Journal
DEN open
ISSN: 2692-4609
Titre abrégé: DEN Open
Pays: Australia
ID NLM: 9918317682706676
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
16
11
2020
revised:
28
01
2021
accepted:
30
01
2021
entrez:
21
3
2022
pubmed:
22
3
2022
medline:
22
3
2022
Statut:
epublish
Résumé
Percutaneous transhepatic biliary drainage (PTBD) is a useful alternative treatment for malignant biliary obstruction (MBO) when patients have difficulty with endoscopic transpapillary drainage. We examined the feasibility of conversion of PTBD to endoscopic ultrasound-guided biliary drainage (EUS-BD) in patients with MBO unsuited for endoscopic transpapillary biliary drainage. This retrospective study included patients who underwent conversion of PTBD to EUS-BD between March 2017 and December 2019. Eligible patients had unresectable MBO, required palliative biliary drainage, and were not suited for endoscopic transpapillary drainage. Initial PTBD had been performed for acute cholangitis or obstructive jaundice in all patients. EUS-BD was performed following improvements in cholangitis. Sixteen patients underwent conversion of PTBD to EUS-BD. We evaluated technical success, procedure time, clinical success (defined as subsequent external catheter removal), adverse events (AEs), time to recurrent biliary obstruction (TRBO), and re-intervention rates. Technical success was achieved in all patients (100%). The median procedure time was 45.0 minutes (interquartile range [IQR] 30.0-50.0 minutes). Clinical success was achieved in all patients (100%). There were mild early AEs in two patients (12.5%) (acute cholangitis: 1, bile peritonitis: 1), which improved with antibiotic administration alone. Recurrent biliary obstruction (RBO) occurred in six patients (37.5%). Kaplan-Meier analysis revealed a 50% TRBO of 95 days (IQR 41-246 days). Endoscopic treatment was possible in all RBO cases, and repeat PTBD was not required. Conversion of PTBD to EUS-BD for the management of MBO is both feasible and safe. This approach is expected to be widely practiced at centers with little experience in EUS-BD.
Identifiants
pubmed: 35310153
doi: 10.1002/deo2.6
pii: DEO26
pmc: PMC8828224
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e6Informations de copyright
© 2021 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.
Déclaration de conflit d'intérêts
The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
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