PMID- 35310153
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220322
IS  - 2692-4609 (Electronic)
IS  - 2692-4609 (Linking)
VI  - 1
IP  - 1
DP  - 2021 Apr
TI  - Conversion of percutaneous transhepatic biliary drainage to endoscopic 
      ultrasound-guided biliary drainage.
PG  - e6
LID - 10.1002/deo2.6 [doi]
LID - e6
AB  - INTRODUCTION: Percutaneous transhepatic biliary drainage (PTBD) is a useful 
      alternative treatment for malignant biliary obstruction (MBO) when patients have 
      difficulty with endoscopic transpapillary drainage. We examined the feasibility 
      of conversion of PTBD to endoscopic ultrasound-guided biliary drainage (EUS-BD) 
      in patients with MBO unsuited for endoscopic transpapillary biliary drainage. 
      METHODS: This retrospective study included patients who underwent conversion of 
      PTBD to EUS-BD between March 2017 and December 2019. Eligible patients had 
      unresectable MBO, required palliative biliary drainage, and were not suited for 
      endoscopic transpapillary drainage. Initial PTBD had been performed for acute 
      cholangitis or obstructive jaundice in all patients. EUS-BD was performed 
      following improvements in cholangitis. Sixteen patients underwent conversion of 
      PTBD to EUS-BD. We evaluated technical success, procedure time, clinical success 
      (defined as subsequent external catheter removal), adverse events (AEs), time to 
      recurrent biliary obstruction (TRBO), and re-intervention rates. RESULTS: 
      Technical success was achieved in all patients (100%). The median procedure time 
      was 45.0 minutes (interquartile range [IQR] 30.0-50.0 minutes). Clinical success 
      was achieved in all patients (100%). There were mild early AEs in two patients 
      (12.5%) (acute cholangitis: 1, bile peritonitis: 1), which improved with 
      antibiotic administration alone. Recurrent biliary obstruction (RBO) occurred in 
      six patients (37.5%). Kaplan-Meier analysis revealed a 50% TRBO of 95 days (IQR 
      41-246 days). Endoscopic treatment was possible in all RBO cases, and repeat PTBD 
      was not required. CONCLUSIONS: Conversion of PTBD to EUS-BD for the management of 
      MBO is both feasible and safe. This approach is expected to be widely practiced 
      at centers with little experience in EUS-BD.
CI  - (c) 2021 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on 
      behalf of Japan Gastroenterological Endoscopy Society.
FAU - Morita, Shinichi
AU  - Morita S
AUID- ORCID: 0000-0003-1608-3827
AD  - Department of Gastroenterology and Hepatology Uonuma Institute of Community 
      Medicine Niigata University Hospital Niigata Japan.
FAU - Sugawara, Shunsuke
AU  - Sugawara S
AD  - Department of Diagnostic Radiology National Cancer Center Hospital Tokyo Japan.
FAU - Suda, Takeshi
AU  - Suda T
AD  - Department of Gastroenterology and Hepatology Uonuma Institute of Community 
      Medicine Niigata University Hospital Niigata Japan.
FAU - Hoshi, Takahiro
AU  - Hoshi T
AD  - Department of Gastroenterology and Hepatology Uonuma Institute of Community 
      Medicine Niigata University Hospital Niigata Japan.
FAU - Abe, Satoshi
AU  - Abe S
AD  - Department of Gastroenterology and Hepatology Uonuma Institute of Community 
      Medicine Niigata University Hospital Niigata Japan.
FAU - Yagi, Kazuyoshi
AU  - Yagi K
AD  - Department of Gastroenterology and Hepatology Uonuma Institute of Community 
      Medicine Niigata University Hospital Niigata Japan.
FAU - Terai, Shuji
AU  - Terai S
AD  - Division of Gastroenterology and Hepatology Graduate School of Medical and Dental 
      Sciences Niigata University Niigata Japan.
LA  - eng
PT  - Journal Article
DEP - 20210421
PL  - Australia
TA  - DEN Open
JT  - DEN open
JID - 9918317682706676
PMC - PMC8828224
OTO - NOTNLM
OT  - adverse event
OT  - endoscopic ultrasound-guided biliary drainage
OT  - malignant biliary obstruction
OT  - percutaneous transhepatic biliary drainage
OT  - recurrent biliary obstruction
OT  - re-intervention
COIS- The authors declare that there is no conflict of interest that could be perceived 
      as prejudicing the impartiality of the research reported.
EDAT- 2022/03/22 06:00
MHDA- 2022/03/22 06:01
PMCR- 2021/04/21
CRDT- 2022/03/21 08:59
PHST- 2020/11/16 00:00 [received]
PHST- 2021/01/28 00:00 [revised]
PHST- 2021/01/30 00:00 [accepted]
PHST- 2022/03/21 08:59 [entrez]
PHST- 2022/03/22 06:00 [pubmed]
PHST- 2022/03/22 06:01 [medline]
PHST- 2021/04/21 00:00 [pmc-release]
AID - DEO26 [pii]
AID - 10.1002/deo2.6 [doi]
PST - epublish
SO  - DEN Open. 2021 Apr 21;1(1):e6. doi: 10.1002/deo2.6. eCollection 2021 Apr.