PMID- 37473780
OWN - NLM
STAT- MEDLINE
DCOM- 20231226
LR  - 20231226
IS  - 1438-8812 (Electronic)
IS  - 0013-726X (Linking)
VI  - 56
IP  - 1
DP  - 2024 Jan
TI  - Endoscopic ultrasound-guided choledochoduodenostomy using single-step 
      lumen-apposing metal stents for primary drainage of malignant distal biliary 
      obstruction (SCORPION-p): a prospective pilot study.
PG  - 47-52
LID - 10.1055/a-2134-3537 [doi]
AB  - BACKGROUND:  This study aimed to assess the safety and feasibility of endoscopic 
      ultrasound-guided choledochoduodenostomy (EUS-CDS) using a lumen-apposing metal 
      stent (LAMS) as a primary drainage strategy in patients with distal malignant 
      biliary obstruction (MBO). METHODS:  A prospective, single-center, pilot study 
      was conducted in patients with pathology-confirmed MBO without gastric outlet 
      obstruction. The primary outcome was technical success. Secondary outcomes 
      included clinical success, adverse events (AEs), and reinterventions. The study 
      was registered in the Netherlands Trial Registry (registry number NL9757). 
      RESULTS:  22 patients were enrolled (median age 69.5 years [interquartile range 
      64-75.3]). Technical success was achieved in 20/22 patients (91 %). AEs occurred 
      in one patient, namely perforation following inadequate stent deployment (5 %), 
      which was treated in the same procedure. Clinical success was achieved in 19/22 
      patients (86 %). Stent dysfunction was observed in 11/20 patients (55 %) after 
      technically successful EUS-CDS: two patients were treated conservatively and nine 
      patients underwent reintervention(s). One patient died within </= 30 days due to 
      fulminant disease progression. CONCLUSIONS:  The results confirmed the safety and 
      feasibility of EUS-CDS using LAMS as a primary drainage strategy. The high 
      incidence of stent dysfunction should be improved before EUS-CDS with LAMS can be 
      seen as a valid alternative to endoscopic retrograde cholangiopancreatography.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution License, permitting unrestricted use, 
      distribution, and reproduction so long as the original work is properly cited. 
      (https://creativecommons.org/licenses/by/4.0/).
FAU - Fritzsche, Jeska A
AU  - Fritzsche JA
AD  - Department of Gastroenterology and Hepatology, Amsterdam UMC, location University 
      of Amsterdam, Amsterdam, The Netherlands.
AD  - Amsterdam Gastroenterology Endocrinology Metabolism, Research Institute, 
      Amsterdam, The Netherlands.
AD  - Treatment and Quality of life, Cancer Center Amsterdam, Amsterdam, The 
      Netherlands.
FAU - Fockens, Paul
AU  - Fockens P
AD  - Department of Gastroenterology and Hepatology, Amsterdam UMC, location University 
      of Amsterdam, Amsterdam, The Netherlands.
AD  - Amsterdam Gastroenterology Endocrinology Metabolism, Research Institute, 
      Amsterdam, The Netherlands.
AD  - Treatment and Quality of life, Cancer Center Amsterdam, Amsterdam, The 
      Netherlands.
AD  - Department of Gastroenterology and Hepatology, Amsterdam UMC, location Vrije 
      Universiteit, Amsterdam, The Netherlands.
FAU - Besselink, Marc G
AU  - Besselink MG
AD  - Amsterdam Gastroenterology Endocrinology Metabolism, Research Institute, 
      Amsterdam, The Netherlands.
AD  - Treatment and Quality of life, Cancer Center Amsterdam, Amsterdam, The 
      Netherlands.
AD  - Department of Surgery, Amsterdam UMC, location University of Amsterdam, 
      Amsterdam, The Netherlands.
FAU - Busch, Olivier R
AU  - Busch OR
AD  - Amsterdam Gastroenterology Endocrinology Metabolism, Research Institute, 
      Amsterdam, The Netherlands.
AD  - Treatment and Quality of life, Cancer Center Amsterdam, Amsterdam, The 
      Netherlands.
AD  - Department of Surgery, Amsterdam UMC, location University of Amsterdam, 
      Amsterdam, The Netherlands.
FAU - Daams, Freek
AU  - Daams F
AD  - Amsterdam Gastroenterology Endocrinology Metabolism, Research Institute, 
      Amsterdam, The Netherlands.
AD  - Treatment and Quality of life, Cancer Center Amsterdam, Amsterdam, The 
      Netherlands.
AD  - Department of Surgery, Amsterdam UMC, location Vrije Universiteit, Amsterdam, The 
      Netherlands.
FAU - Montazeri, Nahid S M
AU  - Montazeri NSM
AD  - Amsterdam Gastroenterology Endocrinology Metabolism, Research Institute, 
      Amsterdam, The Netherlands.
AD  - Department of Gastroenterology and Hepatology, Biostatistics Unit, Amsterdam UMC, 
      location University of Amsterdam, Amsterdam, The Netherlands.
FAU - Wilmink, Johanna W
AU  - Wilmink JW
AD  - Amsterdam Gastroenterology Endocrinology Metabolism, Research Institute, 
      Amsterdam, The Netherlands.
AD  - Treatment and Quality of life, Cancer Center Amsterdam, Amsterdam, The 
      Netherlands.
AD  - Department of Medical Oncology, Amsterdam UMC, location University of Amsterdam, 
      Amsterdam, The Netherlands.
FAU - Voermans, Rogier P
AU  - Voermans RP
AD  - Department of Gastroenterology and Hepatology, Amsterdam UMC, location University 
      of Amsterdam, Amsterdam, The Netherlands.
AD  - Amsterdam Gastroenterology Endocrinology Metabolism, Research Institute, 
      Amsterdam, The Netherlands.
AD  - Treatment and Quality of life, Cancer Center Amsterdam, Amsterdam, The 
      Netherlands.
FAU - Van Wanrooij, Roy L J
AU  - Van Wanrooij RLJ
AUID- ORCID: 0000-0003-0477-4532
AD  - Amsterdam Gastroenterology Endocrinology Metabolism, Research Institute, 
      Amsterdam, The Netherlands.
AD  - Treatment and Quality of life, Cancer Center Amsterdam, Amsterdam, The 
      Netherlands.
AD  - Department of Gastroenterology and Hepatology, Amsterdam UMC, location Vrije 
      Universiteit, Amsterdam, The Netherlands.
LA  - eng
PT  - Clinical Trial
DEP - 20230720
PL  - Germany
TA  - Endoscopy
JT  - Endoscopy
JID - 0215166
SB  - IM
MH  - Aged
MH  - Humans
MH  - *Choledochostomy/adverse effects/methods
MH  - *Cholestasis/etiology/surgery
MH  - *Drainage/methods
MH  - Endosonography/methods
MH  - Pilot Projects
MH  - Prospective Studies
MH  - Stents/adverse effects
MH  - Ultrasonography, Interventional/methods
COIS- P. Fockens is a consultant for Olympus and Cook Endoscopy. J.W. Wilmink reports 
      research grants from Servier, Celgene, Halozyme, Merck, Roche, Pfizer, Amgen, and 
      Novartis, and nonfinancial support from MSD and AstraZeneca. R.P. Voermans 
      reports research grants from Boston Scientific and Prion Medical, has served as a 
      consultant for Cook Medical and Boston Scientific, and has received speaker's 
      fees from Mylan and Zambon. R.L.J. van Wanrooij has served as a consultant for 
      Boston Scientific. All outside the submitted work. J.A. Fritzsche, M.G. 
      Besselink, N.S.M. Montazeri, O.R. Busch, and F. Daams declare that they have no 
      conflict of interest.
EDAT- 2023/07/21 01:12
MHDA- 2023/12/25 06:42
CRDT- 2023/07/20 19:03
PHST- 2023/12/25 06:42 [medline]
PHST- 2023/07/21 01:12 [pubmed]
PHST- 2023/07/20 19:03 [entrez]
AID - 10.1055/a-2134-3537 [doi]
PST - ppublish
SO  - Endoscopy. 2024 Jan;56(1):47-52. doi: 10.1055/a-2134-3537. Epub 2023 Jul 20.