PMID- 35102902
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2303-9027 (Print)
IS  - 2226-7190 (Electronic)
IS  - 2226-7190 (Linking)
VI  - 11
IP  - 3
DP  - 2022 May-Jun
TI  - Comparison of EUS-guided choledochoduodenostomy and percutaneous drainage for 
      distal biliary obstruction: A multicenter cohort study.
PG  - 223-230
LID - 10.4103/EUS-D-21-00031 [doi]
AB  - BACKGROUND AND OBJECTIVES: Percutaneous transhepatic biliary drainage (PTBD) and 
      EUS-guided choledochoduodenostomy (EUS-CD) are alternate therapies to endoscopic 
      retrograde cholangiopancreatography with stent placement for biliary 
      decompression. The primary outcome of this study is to compare the technical and 
      clinical success of PTBD to EUS-CD in patients with distal biliary obstruction. 
      Secondary outcomes were adverse events (AEs), need for reintervention, and 
      survival. METHODS: A multicenter retrospective cohort study from three different 
      centers was performed. Cox regression was used to compare time to reintervention 
      and survival and logistic regression to compare technical and clinical success 
      and AE rates. Subgroup analysis was performed in patients with malignant biliary 
      obstruction (MBO). RESULTS: A total of 86 patients (58 PTBD and 28 EUS-CD) were 
      included. The two groups were similar with respect to age, gender, and cause of 
      biliary obstruction, with malignancy being the most common etiology (80.2%). 
      EUS-CD utilized lumen-apposing metal stents in 15 patients and self-expandable 
      metal biliary stents in 13 patients. Technical success was similar been EUS-CD 
      (100%) and PTBD (96.6%; P = 0.3). EUS-CD was associated with higher clinical 
      success compared to PTBD (84.6% vs. 62.1%; P = 0.04). There was a trend toward 
      lower rates of AEs with EUS-CD 14.3% versus PTBD 29.3%, odds ratio: 0.40 (95% 
      confidence interval [CI]: 0.12-1.33, P = 0.14). The need for reintervention was 
      significantly lower among patients who underwent EUS-CD (10.7%) compared to PTBD 
      (77.6%) (hazard ratio: 0.07, 95% CI: 0.02-0.24; P < 0.001). A sensitivity 
      analysis of only patients with MBO demonstrated similar rate of reintervention 
      between the groups in individuals who survived 50 days or less after the biliary 
      decompression. However, reintervention rates were lower for EUS-CD in those with 
      longer survival. CONCLUSION: EUS-CD is a technically and clinically highly 
      successful procedure with a trend toward lower AEs compared to PTBD. EUS-CD 
      minimizes the need for reintervention, which may enhance end-of-life quality in 
      patients with MBO and expected survival longer than 50 days.
FAU - Sawas, Tarek
AU  - Sawas T
AD  - Division of Digestive and Liver Diseases, University of Texas Southwestern, 
      Dallas, TX, USA.
FAU - Bailey, Natashay J
AU  - Bailey NJ
AD  - Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
FAU - Yeung, Kit Ying Kitty Au
AU  - Yeung KYKA
AD  - Department of Surgery, The Prince of Wales Hospital, Hong Kong, China.
FAU - James, Theodore W
AU  - James TW
AD  - Division of Gastroenterology and Hepatology, University of North Carolina, Chapel 
      Hill, NC, USA.
FAU - Reddy, Sumana
AU  - Reddy S
AD  - Division of Gastroenterology and Hepatology, University of North Carolina, Chapel 
      Hill, NC, USA.
FAU - Fleming, Chad J
AU  - Fleming CJ
AD  - Department of Radiology, Mayo Clinic, Rochester, MN, USA.
FAU - Marya, Neil B
AU  - Marya NB
AD  - Division of Astroenterology and Hepatology, University of Massachusetts, 
      Worcester, MA, USA.
FAU - Storm, Andrew C
AU  - Storm AC
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
FAU - Abu Dayyeh, Barham K
AU  - Abu Dayyeh BK
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
FAU - Petersen, Bret T
AU  - Petersen BT
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
FAU - Martin, John A
AU  - Martin JA
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
FAU - Levy, Michael J
AU  - Levy MJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
FAU - Baron, Todd H
AU  - Baron TH
AD  - Division of Gastroenterology and Hepatology, University of North Carolina, Chapel 
      Hill, NC, USA.
FAU - Bun Teoh, Anthony Yuen
AU  - Bun Teoh AY
AD  - Department of Surgery, The Prince of Wales Hospital, Hong Kong, China.
FAU - Chandrasekhara, Vinay
AU  - Chandrasekhara V
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Endosc Ultrasound
JT  - Endoscopic ultrasound
JID - 101622292
PMC - PMC9258024
OTO - NOTNLM
OT  - distal biliary obstruction
OT  - endoscopic ultrasound-guided choledochoduodenostomy
OT  - malignant biliary obstruction
OT  - percutaneous transhepatic biliary drainage
COIS- None
EDAT- 2022/02/02 06:00
MHDA- 2022/02/02 06:01
PMCR- 2022/01/28
CRDT- 2022/02/01 08:43
PHST- 2022/02/02 06:00 [pubmed]
PHST- 2022/02/02 06:01 [medline]
PHST- 2022/02/01 08:43 [entrez]
PHST- 2022/01/28 00:00 [pmc-release]
AID - 336751 [pii]
AID - EUS-11-223 [pii]
AID - 10.4103/EUS-D-21-00031 [doi]
PST - ppublish
SO  - Endosc Ultrasound. 2022 May-Jun;11(3):223-230. doi: 10.4103/EUS-D-21-00031.