Initial experience with EUS-guided cholangiopancreatography for biliary and pancreatic duct drainage: a Spanish national survey.

Autor: Vila JJ; Department of Gastroenterology, Endoscopy Unit A, Complejo Hospitalario de Navarra, Pamplona, Spain. juanjvila@gmail.com, Pérez-Miranda M, Vazquez-Sequeiros E, Abadia MA, Pérez-Millán A, González-Huix F, Gornals J, Iglesias-Garcia J, De la Serna C, Aparicio JR, Subtil JC, Alvarez A, de la Morena F, García-Cano J, Casi MA, Lancho A, Barturen A, Rodríguez-Gómez SJ, Repiso A, Juzgado D, Igea F, Fernandez-Urien I, González-Martin JA, Armengol-Miró JR
Jazyk: angličtina
Zdroj: Gastrointestinal endoscopy [Gastrointest Endosc] 2012 Dec; Vol. 76 (6), pp. 1133-41. Date of Electronic Publication: 2012 Sep 26.
DOI: 10.1016/j.gie.2012.08.001
Abstrakt: Background: EUS-guided cholangiopancreatography (ESCP) allows transmural access to biliopancreatic ducts when ERCP fails. Data regarding technical details, safety, and outcomes of ESCP are still unknown.
Objective: To evaluate outcomes of ESCP in community and referral centers at the initial development phase of this procedure, to identify the ESCP stages with higher risk of failure, and to evaluate the influence on outcomes of factors related to the endoscopist.
Design: Multicenter retrospective study.
Setting: Public health system hospitals with experience in ESCP in Spain.
Patients: A total of 125 patients underwent ESCP in 19 hospitals, with an experience of <20 procedures.
Intervention: ESCP.
Main Outcome Measurements: Technical success and complication rates in the initial phase of implantation of ESCP are described. The influence of technical characteristics and endoscopist features on outcomes was analyzed.
Results: A total of 125 patients from 19 hospitals were included. Biliary ESCP was performed in 106 patients and pancreatic ESCP was performed in 19. Technical success was achieved in 84 patients (67.2%) followed by clinical success in 79 (63.2%). Complications occurred in 29 patients (23.2%). Unsuccessful manipulation of the guidewire was responsible for 68.2% of technical failures, and 58.6% of complications were related to problems with the transmural fistula.
Limitations: Retrospective study.
Conclusion: Outcomes of ESCP during its implantation stage reached a technical success rate of 67.2%, with a complication rate of 23.2%. Intraductal manipulation of the guidewire seems to be the most difficult stage of the procedure.
(Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.)
Databáze: MEDLINE
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