scholarly journals Endoscopic Ultrasound-Guided Gallbladder Drainage for Aberrant Right Posterior Duct Obstruction Developing after Placement of a Covered Self-Expandable Metallic Stent in a Patient with Distal Biliary Obstruction

2018 ◽  
Vol 12 (3) ◽  
pp. 722-728
Author(s):  
Yuko Suzuki ◽  
Yusuke Hashimoto ◽  
Taro Shibuki ◽  
Motoyasu Kan ◽  
Gen Kimura ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Biliary Obstruction ◽  
Hepatic Duct ◽  
Malignant Biliary Obstruction ◽  
Metallic Stent ◽  
Ultrasound Guided ◽  
Endoscopic Retrograde ◽  
Gallbladder Drainage ◽  
Expandable Metallic Stent ◽  
Distal Malignant Biliary Obstruction

Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has been utilized as an alternative endoscopic technique for patients with acute cholecystitis. In addition to EUS-guided hepaticogastrostomy and EUS-guided cystogastrostomy, EUS-GBD has been reported as being useful for biliary drainage in cases with distal malignant biliary obstruction instead of conventional endoscopic retrograde cholangiopancreatography. We present a case of successful EUS-GBD for malignant obstruction of an aberrant hepatic duct draining directly into the cystic duct.

scholarly journals Self-expandable metallic stent placement above the papilla without endoscopic sphincterotomy in patients with distal malignant biliary obstruction

2020 ◽  
Vol 08 (06) ◽  
pp. E753-E760
Author(s):  
Ryoji Takada ◽  
Kenji Ikezawa ◽  
Ryosuke Kiyota ◽  
Toshihiro Imai ◽  
Yutaro Abe ◽  
...  
Keyword(s):  
Endoscopic Sphincterotomy ◽  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
Complication Rates ◽  
Metallic Stent ◽  
Sems Placement ◽  
Expandable Metallic Stent ◽  
Endoscopic Placement ◽  
Distal Malignant Biliary Obstruction ◽  
First Time

Abstract Background and study aims The best method for endoscopic placement of self-expandable metallic stents (SEMS) for distal malignant biliary obstruction (MBO) has not yet been determined. The aim of this study was to evaluate how SEMS placement above the papilla and without endoscopic sphincterotomy (EST) impacts the time to recurrent biliary obstruction (RBO) in patients with distal MBO. Patients and methods We retrospectively reviewed data for 73 consecutive patients with unresectable distal MBO who underwent endoscopic SEMS placement for the first time at our institution between April 2014 and March 2016. We compared time to RBO of SEMS placement above the papilla (intraductal placement) with SEMS placement across the papilla (transpapillary placement). In the intraductal placement group, we also compared time to RBO of placement without EST with placement with EST. Results Endoscopic SEMS placement was performed in 30 patients with intraductal placement and in 43 patients with transpapillary placement. The median time to RBO was significantly longer with intraductal placement (307 days) than with transpapillary placement (161 days) (P = 0.022). Complication rates did not differ between the two groups. In both univariate and multivariate analysis, intraductal placement was an independent factor contributing to prolonged time to RBO. In intraductal placement, time to RBO was significantly longer in SEMS placement without EST than with EST (363 days vs. 227 days, respectively; P = 0.026). Conclusions Intraductal SEMS placement, especially without EST for distal MBO contributed to longer time to RBO.

Sign in / Sign up

Export Citation Format

Share Document