PMID- 29344562
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220330
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 6
IP  - 1
DP  - 2018 Jan
TI  - Endoscopic ultrasound-guided choledochoduodenostomy using partially-covered 
      self-expandable metal stent in patients with malignant distal biliary obstruction 
      and unsuccessful ERCP.
PG  - E67-E72
LID - 10.1055/s-0043-120664 [doi]
AB  - BACKGROUND AND STUDY AIMS: Endoscopic ultrasound-guided choledochoduodenostomy 
      (EUS-CDS) is an alternative to percutaneous transhepatic biliary drainage (PTBD) 
      for patients with malignant distal biliary obstruction in whom ERCP has failed. 
      We studied technical success, clinical success, stent patency rate and occurrence 
      of adverse events in patients undergoing EUS-CDS with partially-covered 
      self-expanding metal stent (PCSEMS). PATIENTS AND METHODS: Medical records of 
      consecutive patients with unresectable malignant distal biliary obstruction 
      requiring biliary drainage who underwent EUS-CDS because of failure of attempt at 
      ERCP were reviewed. EUS-CDS was done using 6-cm, PCSEMS (Wallflex, Boston 
      Scientific). Technical success, clinical success (more than 50 % reduction in 
      total bilirubin at 2 weeks post-procedure), stent patency rate and adverse events 
      (AEs) were assessed. Patients were followed up for 3 months post-procedure. 
      RESULTS: Between January 2015 and December 2016, 30 patients underwent EUS-CDS, 
      including 20 (67 %) with failed biliary cannulation and 10 (33 %) with duodenal 
      stenosis. Technical success was achieved in 28 patients, all of whom also had 
      clinical success. Median total serum bilirubin decreased from 20 mg/dL to 5 mg/dL 
      at 2 weeks post-procedure. Three patients (10 %) had adverse events (bile leak, 
      hemobilia, stent block in one patient each; no stent migration); none of these 
      adverse events was major and all were managed successfully. There were no 
      procedure-related deaths. Five patients died of disease progression in the 
      3-month period post-procedure, and the 3-month dysfunction-free stent patency 
      rate was 83 %. CONCLUSION: EUS-CDS with a PCSEMS has a high technical and 
      clinical success. Adverse events were infrequent, minor and could be managed 
      easily.
FAU - Rai, Praveer
AU  - Rai P
AD  - Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow, India.
FAU - Lokesh, C R
AU  - Lokesh CR
AD  - Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow, India.
FAU - Goel, Amit
AU  - Goel A
AD  - Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow, India.
FAU - Aggarwal, Rakesh
AU  - Aggarwal R
AD  - Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow, India.
LA  - eng
PT  - Journal Article
DEP - 20180116
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC5770273
COIS- Competing interests None
EDAT- 2018/01/19 06:00
MHDA- 2018/01/19 06:01
PMCR- 2018/01/01
CRDT- 2018/01/19 06:00
PHST- 2017/06/08 00:00 [received]
PHST- 2017/08/31 00:00 [accepted]
PHST- 2018/01/19 06:00 [entrez]
PHST- 2018/01/19 06:00 [pubmed]
PHST- 2018/01/19 06:01 [medline]
PHST- 2018/01/01 00:00 [pmc-release]
AID - 10.1055/s-0043-120664 [doi]
PST - ppublish
SO  - Endosc Int Open. 2018 Jan;6(1):E67-E72. doi: 10.1055/s-0043-120664. Epub 2018 Jan 
      16.