PMID- 33140019
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201104
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 8
IP  - 11
DP  - 2020 Nov
TI  - Safety and outcomes of endoscopic ultrasound-guided drainage for malignant 
      biliary obstruction using cautery-enabled lumen-apposing metal stent.
PG  - E1633-E1638
LID - 10.1055/a-1236-3217 [doi]
AB  - Background and study aims  There is increasing evidence to suggest that 
      EUS-guided biliary drainage (EUS-BD) is a safe and effective treatment 
      alternative for patients with malignant biliary obstructions (MBOs) after failed 
      endoscopic retrograde cholangiopancreatography. Patients and methods  We 
      performed a retrospective analysis of data prospectively collected from patients 
      with MBO who underwent choledochoduodenostomy (CDS) or gallbladder drainage (GBD) 
      between August 2016 and June 2020 using the electrocautery-enabled lumen-apposing 
      metal stents (ECE-LAMS). The primary endpoint was technical and clinical success. 
      Secondary endpoints were adverse events (AEs) and reinterventions. Results  A 
      total of 60 patients were included in the study, with 56 CDS and 4 GBD. Median 
      age was 76 years with 57 % male (34/60). The most common indication for EUS-BD 
      was pancreatic cancer (78 %). Technical success was achieved in 100 % of cases, 
      with a clinical success rate of 91.7 %. Mean total bilirubin pre-procedure was 
      202 umol/L (normal < 20 umol/L) and 63.8 umol/L post procedure ( P  < .001). 
      Twenty-one patients had bilirubin recorded at 2 weeks post EUS-BD with 20 of 21 
      patients demonstrating > 50 % reduction in bilirubin (mean bilirubin reduction 
      75 %). AEs occurred in 12 of 60 patients (20 %), all of which were mild. The 
      reintervention rate was 11.7 % (7/60). Stent occlusion occurred in 10 of 60 
      patients (16.7 %) with a mean time to stent occlusion of 46.2 days (3-133). Stent 
      patency of 83.3 % was observed with a mean follow up of 7.9 months. Conclusion 
       EUS-CDS and GBD using ECE-LAMS are effective EUS-based techniques for managing 
      patients with MBO. AEs are usually mild and resolved by reintervention.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commecial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Chin, Jerry Yung-Lun
AU  - Chin JY
AD  - Department of Gastroenterology and Hepatology, Waikato Hospital, Hamilton, New 
      Zealand.
FAU - Seleq, Samir
AU  - Seleq S
AD  - Department of Gastroenterology and Hepatology, Waikato Hospital, Hamilton, New 
      Zealand.
FAU - Weilert, Frank
AU  - Weilert F
AD  - Department of Gastroenterology and Hepatology, Waikato Hospital, Hamilton, New 
      Zealand.
LA  - eng
PT  - Journal Article
DEP - 20201022
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC7581482
COIS- Competing interests The authors declare that they have no conflict of interest.
EDAT- 2020/11/04 06:00
MHDA- 2020/11/04 06:01
PMCR- 2020/11/01
CRDT- 2020/11/03 05:47
PHST- 2020/05/09 00:00 [received]
PHST- 2020/07/15 00:00 [accepted]
PHST- 2020/11/03 05:47 [entrez]
PHST- 2020/11/04 06:00 [pubmed]
PHST- 2020/11/04 06:01 [medline]
PHST- 2020/11/01 00:00 [pmc-release]
AID - 10.1055/a-1236-3217 [doi]
PST - ppublish
SO  - Endosc Int Open. 2020 Nov;8(11):E1633-E1638. doi: 10.1055/a-1236-3217. Epub 2020 
      Oct 22.