Document Type
Article
Publication Date
11-1-2018
Abstract
Background and Objectives: EUS-guided biliary drainage (EUS-BD) was shown to be useful for malignant biliary obstruction (MBO). However, there is lack of consensus on how EUS-BD should be performed.
Methods: This was a worldwide multi-institutional survey among members of the International Society of EUS conducted in February 2018. The survey consisted of 10 questions related to the practice of EUS-BD.
Results: Forty-six endoscopists of them completed the survey. The majority of endoscopists felt that EUS-BD could replace percutaneous transhepatic biliary drainage after failure of ERCP. Among all EUS-BD methods, the rendezvous stenting technique should be the first choice. Self-expandable metal stents (SEMSs) were recommended by most endoscopists. For EUS-guided hepaticogastrostomy (HGS), superiority of partially-covered SEMS over fully-covered SEMS was not in agreement. 6-Fr cystotomes were recommended for fistula creation. During the HGS approach, longer SEMS (8 or 10 cm) was recommended. During the choledochoduodenostomy approach, 6-cm SEMS was recommended. During the intrahepatic (IH) approach, the IH segment 3 was recommended.
Conclusion: This is the first worldwide survey on the practice of EUS-BD for MBO. There were wide variations in practice, and randomized studies are urgently needed to establish the best approach for the management of this condition.
Recommended Citation
Guo, Jintao; Giovannini, Marc; Sahai, Anand V.; Saftoiu, Adrian; Dietrich, Christoph F.; Santo, Erwin; Fusaroli, Pietro; Siddiqui, Ali; Bhutani, Manoop S.; Bun Teoh, Anthony Yuen; Irisawa, Atsushi; Arturo Arias, Brenda Lucia; Achanta, Chalapathi Rao; Jenssen, Christian; Seo, Dong-Wan; Adler, Douglas G.; Kalaitzakis, Evangelos; Artifon, Everson; Itokawa, Fumihide; Poley, Jan Werner; Mishra, Girish; Ho, Khek Yu; Wang, Hsiu-Po; Okasha, Hussein Hassan; Lachter, Jesse; Vila, Juan J.; Iglesias-Garcia, Julio; Yamao, Kenji; Yasuda, Kenjiro; Kubota, Kensuke; Palazzo, Laurent; Sabbagh, Luis Carlos; Sharma, Malay; Kida, Mitsuhiro; El-Nady, Mohamed; Nguyen, Nam Q.; Vilmann, Peter; Garg, Pramod Kumar; Rai, Praveer; Mukai, Shuntaro; Carrara, Silvia; Parupudi, Sreeram; Sridhar, Subbaramiah; Lakhtakia, Sundeep; Rana, Surinder S; Ogura, Takeshi; Baron, Todd H.; Dhir, Vinay; and Sun, Siyu, "A multi-institution consensus on how to perform EUS-guided biliary drainage for malignant biliary obstruction." (2018). Division of Gastroenterology and Hepatology Faculty Papers. Paper 53.
https://jdc.jefferson.edu/gastro_hepfp/53
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.
PubMed ID
30531022
Language
English
Comments
This article has been peer reviewed. It is the author’s final published version in Endoscopic Ultrasound, Volume 7, Issue 6, November-December 2018, Pages 356-365.
The published version is available at https://doi.org/10.4103/eus.eus_53_18. Copyright © Guo et al.