A retrospective comparative study of biliary drainage using balloon endoscopy and endoscopic ultrasound for malignant obstruction in patients with surgically altered anatomy.

Autor: Hakuta R; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Ishida K; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Nakai Y; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. ynakai-tky@umin.ac.jp.; Department of Endoscopy and Endoscopic Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan. ynakai-tky@umin.ac.jp., Kogure H; Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan., Nishio H; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Kurihara K; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Tange S; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Fukuda R; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Takaoka S; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Suzuki Y; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Oyama H; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Kanai S; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Noguchi K; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Suzuki T; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Sato T; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Ishigaki K; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.; Department of Chemotherapy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Saito T; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Hamada T; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.; Department of Hepato-Biliary-Pancreatic Medicine, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan., Takahara N; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Fujishiro M; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2024 Dec; Vol. 38 (12), pp. 7269-7277. Date of Electronic Publication: 2024 Oct 14.
DOI: 10.1007/s00464-024-11329-1
Abstrakt: Background and Aims: Endoscopic biliary drainage for malignant biliary obstruction (MBO) in patients with surgically altered anatomy is challenging, and technical difficulty could differ by the anatomy. Balloon endoscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP) and endoscopic ultrasonography-guided biliary drainage (EUS-BD) are both emerging procedures, and we conducted the single-center, retrospective study to compare clinical outcomes of BE-ERCP and EUS-BD for MBO.
Methods: Consecutive patients with surgically altered anatomy who underwent BE-ERCP or EUS-BD for MBO were retrospectively studies. Technical and clinical success rates, adverse events (AEs), and time to recurrent biliary obstruction (TRBO) were compared.
Results: Patient characteristics were comparable between BE-ERCP (n = 118) and EUS-BD (n = 32), other than more patients with hepaticojejunostomy in the BE-ERCP group (66% vs. 44%, P = 0.03). Technical success rate was significantly higher in the EUS-BD group (70% vs. 94%, P = 0.005), but clinical success rates (84% vs. 90%, P = 0.55), early AE (14% vs. 22%, P = 0.29) and late AE rates (42% vs. 38%, P = 0.84), and RBO rates (31% vs. 34%, P = 0.67) were comparable between the groups. TRBO was 170 and 206 days in the BE-ERCP and EUS-BD group (P = 0.37). In the subgroup analysis of patients with the intact papilla, the technical success rate of BE-ERCP was as low as 55%, compared to 94% in EUS-BD (P = 0.003).
Conclusion: EUS-BD was associated with higher technical success rate than BE-ERCP for MBO in patients with surgically altered anatomy.
Competing Interests: Declarations. Disclosures: Yousuke Nakai and Mitsuhiro Fujishiro received research grant and honoraria from Fujifilm Corporation. Ryunosuke Hakuta, Kota Ishida, Hirofumi Kogure, Hiroto Nishio, Kouhei Kurihara, Shuichi Tange, Rintaro Fukuda, Shinya Takaoka, Yukari Suzuki, Hiroki Oyama, Sachiko Kanai, Kensaku Noguchi, Tatsunori Suzuki, Tatsuya Sato, Kazunaga Ishigaki, Tomotaka Saito, Tsuyoshi Hamada, and Naminatsu Takahara have no conflicts of interest or financial ties to disclose.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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