Abstract:
BACKGROUND:EUS-guided biliary drainage (BD) is an evolving alternative technique for patients with malignant biliary obstruction for which ERCP failed. OBJECTIVE:To compare the outcomes of 2 nonanatomic EUS-guided BD routes: hepaticogastrostomy (HPG) and choledochoduodenostomy (CD). DESIGN:Prospective, randomized trial. SETTING:Tertiary endoscopic referral center. PATIENTS:Forty-nine patients with unresectable distal malignant biliary obstruction and failed ERCP were included. The HPG group had 25 patients and the CD group had 24 patients. INTERVENTIONS:EUS-guided HPG or CD. In all procedures, a biliary puncture with a 19-gauge needle followed by cholangiography, wire advancement, track dilation, and self-expandable metal stent deployment were performed. MAIN OUTCOME MEASUREMENTS:Technical and clinical success, quality of life, adverse events, and survival. RESULTS:The technical success rate was 96% for HPG and 91% for CD. The clinical success rate was 91% for HPG and 77% for CD. The mean procedural time was 47.8 minutes for HPG and 48.8 minutes for CD. The mean scores of quality of life were similar during follow-up. The overall adverse event rate was 16.3% (20% for the HPG group and 12.5% for the CD group). One patient with a bile leak required percutaneous biloma drainage. There was no statistical difference between the 2 techniques and no difference with regard to survival time between the 2 groups. LIMITATIONS:Single-center study. CONCLUSION:HPG and CD techniques are similar in efficacy and safety. Both HPG and CD seem valid alternative options for BD in patients with distal malignant biliary obstruction after failed ERCP.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Artifon EL,Marson FP,Gaidhane M,Kahaleh M,Otoch JPdoi
10.1016/j.gie.2014.09.047subject
Has Abstractpub_date
2015-04-01 00:00:00pages
950-9issue
4eissn
0016-5107issn
1097-6779pii
S0016-5107(14)02267-6journal_volume
81pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Wireless capsule endoscopy (CE) is the investigation of choice in obscure GI bleeding (OGIB), with a high diagnostic yield when compared with other modalities. It enables specific treatment to be instigated in a significant proportion of cases, with the aim of reducing rebleeding rates. Little evidence is cu...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.06.054
更新日期:2008-12-01 00:00:00
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journal_title:Gastrointestinal endoscopy
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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更新日期:2002-05-01 00:00:00
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journal_title:Gastrointestinal endoscopy
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更新日期:2000-02-01 00:00:00
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journal_title:Gastrointestinal endoscopy
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更新日期:2000-09-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/j.gie.2014.11.035
更新日期:2015-03-01 00:00:00
abstract::Fifty-two self-expanding metal stents were implanted in 39 patients with malignant (35 patients) or benign (4 patients) biliary stenoses. The stents were inserted and properly released by means of a 7 or 9 French gauge delivery catheter via the percutaneous (20 patients) or transpapillary (19 patients) route. In all c...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
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更新日期:1991-01-01 00:00:00
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journal_title:Gastrointestinal endoscopy
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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journal_title:Gastrointestinal endoscopy
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.108966
更新日期:2001-02-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(99)70222-1
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journal_title:Gastrointestinal endoscopy
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更新日期:2020-09-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0016-5107(95)70192-3
更新日期:1995-06-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2005-05-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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