scholarly journals Indications for Endoscopic Ultrasound-Guided Pancreatic Drainage: For Benign or Malignant Cases?

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Daisuke Uchida ◽  
Hironari Kato ◽  
Yosuke Saragai ◽  
Saimon Takada ◽  
Sho Mizukawa ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Clinical Success ◽  
Stent Migration ◽  
Success Rates ◽  
Recurrent Pancreatitis ◽  
Ultrasound Guided ◽  
Appropriate Treatment ◽  
Long Term Follow Up

Background and Aims. Recurrent pancreatitis associated with pancreatic strictures requires treatment with endoscopic retrograde pancreatography (ERP), but it is sometimes technically unsuccessful. Endoscopic ultrasound-guided pancreatic drainage (EUS-PD) was developed as an alternative to a surgical approach after failed ERP; however, the indications for EUS-PD are unclear. In this study, we evaluated the outcomes of EUS-PD and established the indications for EUS-PD. Methods. A total of 15 patients had indications for EUS-PD for recurrent pancreatitis due to pancreatic strictures. There were eight patients with benign pancreatic strictures and seven with malignant pancreatic strictures. The success rate, adverse events, and long-term outcomes were evaluated. Results. The technical success rates of benign and malignant strictures were 75% (6/8) and 100% (7/7), respectively, and clinical success was achieved in 100% (6/6) and 87.5% of cases (6/7), respectively. Rendezvous procedures were performed in two patients with benign strictures. The adverse event (AE) rate was 26.7% (4/15) and included cases of peritonitis, bleeding, and stent migration. Reinterventions were performed in three patients with benign strictures and two with malignant strictures. Conclusions. EUS-PD was an appropriate treatment for not only benign strictures but also malignant strictures with recurrent pancreatitis after failed ERP. However, the AE rate was high, and reinterventions were required in some cases during long-term follow-up. The indications for EUS-PD should be considered carefully, and careful follow-up is needed.

scholarly journals Endoscopic ultrasound-guided gastroenterostomy using large-diameter (20 mm) lumen apposing metal stent (LLAMS)

2021 ◽  
Vol 09 (06) ◽  
pp. E895-E900
Author(s):  
Zain A. Sobani ◽  
Swathi Paleti ◽  
Tarun Rustagi
Keyword(s):  
Endoscopic Ultrasound ◽  
Clinical Success ◽  
Large Diameter ◽  
Outlet Obstruction ◽  
Jejunal Ulcer ◽  
Metal Stent ◽  
Ultrasound Guided ◽  
Regular Diet

Abstract Background and study aims Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using a 15-mm lumen apposing metal stent (LAMS) has emerged as a viable alternative to surgical gastrojejunostomy for management of gastric outlet obstruction (GOO). However, given the size of the anastomosis created with a 15-mm LAMS, long-term luminal patency and clinical outcomes may be suboptimal. The aim of this study was to evaluate the technical feasibility, efficacy, and safety of EUS-GE with a large-diameter (20 mm) LAMS (LLAMS). Patients and methods A retrospective analysis of a prospectively maintained database of all patients undergoing EUS-GE with LLAMS between December 1, 2018 and September 30, 2020 was performed. All EUS-GEs were performed using a cautery-enhanced LLAMS. Results Thirty-three patients were referred for endoscopic management of GOO. Two patients were excluded due to a lack of an adequate window for EUS-GE. The remaining 31 patients (93.94 %) (mean age: 61.35 ± 16.52 years; 54.84 % males) underwent EUS-GE using LLAMS for malignant (n = 23) and benign (n = 8) GOO. Technical success was achieved in all patients (100 %) with attempted EUS-GE. Complete clinical success (tolerance of regular diet) was achieved in 93.55 % of patients (n = 29). Two patients (6.45 %) had partial clinical success and died of unrelated causes prior to advancing diet beyond full liquids. Overall mean follow-up was 140.84 ± 160.41 days (median 70, range 4–590). All stents remained patent with no evidence of recurrent GOO symptoms. One patient (3.23 %) developed an asymptomatic clean-based jejunal ulcer on 3-month follow-up endoscopy. Conclusions EUS-GE with LLAMS is a technically feasible, effective and safe option for patients with GOO allowing for tolerability of regular diet. Future prospective, ideally randomized studies comparing long-term outcomes of EUS-GE with 20- and 15-mm LAMS are required.

scholarly journals Effectiveness and safety of a single 7-french plastic stent for endoscopic ultrasound-guided pancreatic pseudocyst drainage and long-term follow-up outcomes

2021 ◽  
Vol 29 (4) ◽  
pp. 250
Author(s):  
Nonthalee Pausawasdi ◽  
Manus Rugivarodom ◽  
Pongprueth Rujirachun ◽  
Phunchai Charatchareonwitthaya ◽  
Tanyaporn Chantarojanasiri ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Pancreatic Pseudocyst ◽  
Ultrasound Guided ◽  
Plastic Stent ◽  
Long Term Follow Up ◽  
Pseudocyst Drainage

Endoscopic ultrasound-guided drainage of abdominal fluid collections after pancreatic surgery: Efficacy and long-term follow-up

2016 ◽  
Vol 54 (09) ◽  
pp. 1047-1053 ◽  
Author(s):  
U. Denzer ◽  
A. Sioulas ◽  
M. Abdulkarim ◽  
S. Groth ◽  
T. Rösch ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Pancreatic Surgery ◽  
Ultrasound Guided ◽  
Long Term Follow Up ◽  
Fluid Collections

scholarly journals Mo1288 RESULTS OF LONG-TERM FOLLOW UP OF ENDOSCOPIC ULTRASOUND-GUIDED GALLBLADDER DRAINAGE FOR ACUTE CHOLECYSTITIS

2018 ◽  
Vol 87 (6) ◽  
pp. AB430
Author(s):  
Omar Ahmed ◽  
Takeshi Ogura ◽  
Hanaa Khalaf ◽  
Ehab Mohammed ◽  
Ayat Sameer ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Endoscopic Ultrasound ◽  
Ultrasound Guided ◽  
Gallbladder Drainage ◽  
Long Term Follow Up

Analysis of branch artery orifice angulation: Feasibility of the shelf technique for the treatment of wide-neck bifurcation aneurysms

2020 ◽  
pp. 159101992097625
Author(s):  
Mehmet Onay ◽  
Ali Burak Binboga ◽  
Cetin Murat Altay
Keyword(s):  
Excellent Agreement ◽  
Clinical Success ◽  
Success Rates ◽  
Angle Measurements ◽  
Long Term Follow Up ◽  
Double Stent ◽  
Α Angle ◽  
Wide Neck

Background and purpose The aim of this study was to investigate the feasibility of the shelf technique by analyzing the angle between the two branch orifices and to present its safety and effectiveness compared with that of the double-stent technique. Materials and methods Patients with complex wide-neck bifurcation aneurysms (WNBAs) who underwent stent-assisted coiling (SAC) were reviewed. The study sample was divided into two groups: single SAC (shelf technique) and double SAC. The angle between the lines connecting the superior and inferior points of each branch orifice (α angle) was measured by two neurointerventional radiologists in both groups. The inter- and intraobserver repeatability and consistency of the α angle were assessed. The effect of the α angle on the feasibility of using the shelf technique to treat WNBA was analyzed. Technical and clinical success rates were investigated by comparing both groups. Results Forty-eight patients (32 shelf technique and 16 double-stent technique) were included. There was excellent agreement between the intra- and interobserver repeatability and consistency of α angle measurements. The α angle was smaller in the shelf technique group than in the double-SAC group (p < 0.001). The technical and clinical success rates of both groups were similar based on long-term follow-up (p > 0.05). Conclusion WNBA treatment with the shelf technique is safe and effective. The α angle is a useful parameter to evaluate the performance of the shelf technique. The shelf technique is more suitable for WNBAs with a narrow α angle.

scholarly journals Endoscopic ultrasound-guided hepaticogastrostomy or hepaticojejunostomy without dilation using a stent with a thinner delivery system

2020 ◽  
Vol 08 (08) ◽  
pp. E1034-E1038
Author(s):  
Kosuke Maehara ◽  
Susumu Hijioka ◽  
Yoshikuni Nagashio ◽  
Akihiro Ohba ◽  
Yuta Maruki ◽  
...  
Keyword(s):  
Delivery System ◽  
Endoscopic Ultrasound ◽  
Clinical Success ◽  
Small Diameter ◽  
Stent Migration ◽  
Metallic Stent ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Stent Occlusion ◽  
Expandable Metallic Stent

Abstract Background and study aim Use of endoscopic ultrasound-guided biliary drainage (EUS-BD) has recently increased. In EUS-BD, after puncturing the bile duct, dilation is performed and the stent is deployed. Due to adverse events (AEs) such as unexpected displacement of the guidewire, simplified procedures are required. Currently, stents with small-diameter delivery systems are being rapidly developed, expanding the possibilities for of EUS-BD without dilation. In this retrospective study, we aimed to evaluate the success rates and AEs in patients who underwent EUS-guided hepaticogastrostomy (EUS-HGS) or EUS-guided hepaticojejunostomy (EUS-HJS) without dilation. Patients and methods Six consecutive patients with malignant biliary obstruction and failed transpapillary BD underwent EUS-HGS or EUS-HJS without dilation, deploying a 6-mm fully-covered self-expandable metallic stent with a 6-Fr delivery system. Results The technical and clinical success rates were 100 %. There was one case each of stent migration and stent occlusion, and no other AEs were noted. Conclusions EUS-HGS or EUS-HJS without dilation using a stent with a 6-Fr delivery system had high technical and clinical success rates; however, additional cases are required to validate the study findings.

scholarly journals Endoscopic ultrasound-guided gallbladder drainage: Results of long-term follow-up

2018 ◽  
Vol 24 (3) ◽  
pp. 183 ◽  
Author(s):  
Takeshi Ogura ◽  
Omar Ahmed ◽  
Ali Eldahrouty ◽  
Hanaa Khalaf ◽  
Ehab Mohammed ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Ultrasound Guided ◽  
Gallbladder Drainage ◽  
Long Term Follow Up

Conversion of external percutaneous transhepatic biliary drainage to endoscopic ultrasound-guided hepaticogastrostomy after failed standard internal stenting for malignant biliary obstruction

Endoscopy ◽  
2017 ◽  
Vol 49 (06) ◽  
pp. 544-548 ◽  
Author(s):  
Woo Paik ◽  
Nah Lee ◽  
Yousuke Nakai ◽  
Hiroyuki Isayama ◽  
Dongwook Oh ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Biliary Drainage ◽  
Biliary Obstruction ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Clinical Success ◽  
Stent Migration ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Stent Patency ◽  
Transhepatic Biliary Drainage

Abstract Background and study aim Percutaneous transhepatic biliary drainage (PTBD) is a rescue procedure after a failed endoscopic retrograde cholangiopancreatography. As PTBD causes patient discomfort, conversion of the PTBD to internal biliary stenting (PTBDS) may be required; however, PTBDS is sometimes difficult because of the tight stricture. We evaluated the efficacy and safety of conversion of external PTBD to endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) after failed PTBDS. Patients and methods A total of 16 patients with malignant distal biliary obstruction who underwent conversion of external PTBD to EUS-HGS after failed PTBDS were enrolled from two institutions in Korea and Japan. Data were analyzed retrospectively. Results The technical and clinical success rates were 100 % and 81 %, respectively. Early adverse events developed in two patients: proximal stent migration (n = 1), and cholecystitis (n = 1). Stents were occluded or migrated distally in five patients. The mean duration of stent patency was 402 days. Conclusions Conversion of external PTBD to EUS-HGS may be a good rescue option after failed PTBDS.

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