EUS-guided biliary drainage in patients with distal malignant biliary obstruction requires fewer interventions and has a lower cost compared to ERCP biliary drainage

Autor: Jesús Ramírez-García, Mónica Auxiliadora Figueredo-Zacarías, José Froylan Rodríguez-Sánchez, Miguel Ángel Ramírez-Luna, Everardo Muñoz-Anaya, Francisco Valdovinos-Andraca, Félix I. Téllez-Ávila
Rok vydání: 2020
Předmět:
Zdroj: Surgical Endoscopy. 35:2531-2536
ISSN: 1432-2218
0930-2794
DOI: 10.1007/s00464-020-07667-5
Popis: Endoscopic retrograde cholangiopancreatography (ERCP) biliary drainage is considered the reference standard in patients with biliary obstruction, but it is not free of complications. EUS-guided biliary drainage (EUS-BD) is considered an alternative in patients with failed ERCP; however, data are scarce as to whether EUS-BD could be considered a first option. The aim of our study was to compare the need for reintervention and cost between ERCP biliary drainage vs. EUS-BD. We conducted a retrospective and comparative study of patients with distal malignant biliary obstruction with biliary drainage with ERCP + plastic stent (ERCP-PS) vs. ERCP + metal stent (ERCP-MS) vs. EUS-BD. 124 patients were included, divided into three groups: ERCP-PS, 60 (48.3%) patients; ERCP-MS, 40 (32.2%) patients; and EUS-BD, 24 (19.3%) patients. The need for reinterventions (67 vs. 37 vs. 4%, respectively), the number of procedures [3 (1–10) vs. 2 (1–7) vs. 1 (1–2)], and the costs (4550 ± 3130 vs. 5555 ± 3210 vs. 2375 ± 1020 USD) were lower in the EUS-BD group. No differences in terms of complications were detected. EUS-BD requires fewer reinterventions and has a lower cost compared to drainage by ERCP with metal or plastic stents.
Databáze: OpenAIRE
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