Su1569 Systemic Effect of EUS-Guided Pancreatic Cyst Ablation With Ethanol and Paclitaxel

Autor: Hyoung-Chul Oh, Ji Yeong Kim, Bumchan Min, Su Hui Kim, Dong Wan Seo
Rok vydání: 2013
Předmět:
Zdroj: Gastrointestinal Endoscopy. 77:AB371
ISSN: 0016-5107
DOI: 10.1016/j.gie.2013.03.1222
Popis: surgery. However, the recently developed lumen-apposing self-expandable AXIOSTM stent, has emerged like a choice for endoscopic ultrasound-guided transenteric gallbladder drainage (EUS-GBD). Preliminary studies -Itoi & Binmoeller, GIE 2012;75 (4)-report a high-rate of technical and clinical success. We aimed to evaluate the short & mid-term results of GBD in high surgical risk AC patients comparing safety, technical feasibility and efficacy of EUS-AXIOSTMGBD and those of PTGBD. Materials and Methods: From June 2011 to October 2012, 22 patients (14 male/8 female; mean age: 81.92) with non-surgical AC underwent EUS-AXIOSTM-GBD. The procedure was performed with linear echoendoscopes, 19G needles under EUS & fluoroscopic control, 0.035 inch guidewires, 8.5F cystotomes and 4 mm biliary balloon dilators. AXIOS stents 10x 10 or 10x 15 mm were used. Eventually a standard or ultraslim gastroscope was advanced through the stent for cholecystoscopy, lavage or stone retrieval . An experimental, retrospective, non-randomized study, was designed to compare this group (A) with an historic PTGBD control group (B) of 54 randomly selected, surgical high-risk CA patients recruited between October 2008 to October 2012. Data were analized using SPSS 11 v. 5.1. Results: Follow-Up (mean weeks): Group A: 40.83 (range 6-55); Group B: 87,63 (4-152). Both groups showed homogeneity concerning age, sex, comorbidities & ASA score. EUS-GBS and PTGBD didn’t show significative differences about: 1.-Technical success (19 of 22; 86.37% vs 51 of 54; 94.4% 2.-Clinical success: 19 of 19:100% vs 47 of 51:92.15%, p .001, 3.-Mean interval drainage-discharge : 12.64 days vs 15.49, and 4.-Procedure-related complications: 5 of 22; 22.78% vs 11 of 54; 20.37%, . Percentage of recurrences was significantly lower in group A: 2 of 19: 10.52% vs group B: 22/54: 40.70% . This difference was most likely explaned by maintenance of effective internal GB drainage by indwelling AXIOSTM stents, whereas external PTGB catheters were removed. Conclusions: 1-EUS-AXIOSTMGBD and PTGBD appear to provide similar results in terms of efficacy and safety. 2PTGBD group shows a higher rate of AC recurrence during followup.3.This finding favours EUS-GBD Vs PTGBD in this patient subset, however prospective, randomized studies are needed.
Databáze: OpenAIRE
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