Endoscopic ultrasonography-guided biliary drainage.

Abstract

BACKGROUND AND PURPOSE:

Endoscopic ultrasonography-guided biliary drainage (EUS-BD) has been developed as an alternative drainage method in patients with obstructive jaundice. EUS-BD is divided into EUS-guided choledochoduodenostomy (EUS-CDS), EUS-guided hepaticogastrostomy (EUS-HGS) and EUS-guided gallbladder drainage (EUS-GBD). The aim of this review is to focus on the current status and limitations of EUS-BD.

METHODS:

A systematic review was performed to evaluate EUS-BD. MEDLINE, EMBASE and manual searches were performed to identify the pertinent English language full articles.

RESULTS:

The high success rate without fatal adverse events for EUS-CDS (93%; 28/30) and EUS-HGS (97%; 28/29) suggest the feasibility and safety of the procedures in high-volume endoscopic centers adopting various procedural techniques. Although the number of reported cases was very small, the success rate of EUS-GBD was high (100%; 14/14), without serious adverse events.

CONCLUSIONS:

Although all procedures require further assessment in a larger cohort of patients, including comparative studies between EUS-CDS or EUS-HGS versus PTBD, and EUS-GBD versus PTGBD, EUS-BD may be a promising procedure for the treatment of obstructive jaundice. However, dedicated devices for EUS-guided drainage are needed for reliable procedures.

• Authors: Takao Itoi, Atsushi Sofuni, Fumihide Itokawa, Takayoshi Tsuchiya, Toshio Kurihara, Kentaro Ishii, Shujiro Tsuji, Nobuhito Ikeuchi, Junko Umeda, Fuminori Moriyasu, Akihiko Tsuchida
• Journal: Journal of hepato-biliary-pancreatic sciences (J Hepatobiliary Pancreat Sci) Vol. 17 Issue 5 Pg. 611-6 (Sep 2010) ISSN: 1868-6982 [Electronic] Japan
• PMID: 19806298 (Publication Type: Journal Article, Review, Systematic Review)

Topics

• Bile Ducts (diagnostic imaging)
• Choledochostomy (methods)
• Drainage (methods)
• Endosonography (methods)
• Humans
• Jaundice, Obstructive (diagnostic imaging, therapy)
• Reproducibility of Results