Unit of Gastroenterology and Digestive Endoscopy, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy.
Unit of Gastroenterology and Digestive Endoscopy, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy.
Dig Liver Dis. 2020 Jan;52(1):57-63. doi: 10.1016/j.dld.2019.07.009. Epub 2019 Aug 10.
Endoscopic retrograde cholangiopancreatography (ERCP) with the placement of a biliary stent is the treatment of choice for palliation of malignant obstructive jaundice. In 5-10% of cases ERCP fails. In these cases an effective alternative is endoscopic ultrasonography-guided biliary drainage (EUS-BD).
Evaluation of the principal clinical outcomes of direct transluminal EUS-BD.
This study is a retrospective analysis. All consecutive patients with malignant obstructive jaundice, in whom ERCP had failed, were enrolled. The primary outcome was the technical success of EUS-BD defined as the correct placement of the metal or plastic stent across the stomach or duodenum to the biliary tree. The most important secondary outcomes were early and late clinical success, both linked to the decrease of bilirubin haematic level.
Between January 2011 and November 2017 thirty-six patients were included. Technical success was obtained in 91.6%. A clinical success, early or late was obtained in 75.8%. The ECOG performance status of less than 3 was correlated with clinical success. Adverse events occurred in 30.3% of patients.
EUS-BD is an effective and safe procedure.
内镜逆行胰胆管造影术（ERCP）联合胆管支架置入术是治疗恶性梗阻性黄疸的首选方法。然而，在 5-10%的病例中，ERCP 会失败。在这些情况下，有效的替代方法是超声内镜引导下胆道引流术（EUS-BD）。
评估直接经腔超声内镜引导下胆道引流术（EUS-BD）的主要临床结局。
这是一项回顾性分析。所有因 ERCP 失败而患有恶性梗阻性黄疸的连续患者均被纳入研究。主要结局是 EUS-BD 的技术成功率，定义为金属或塑料支架正确穿过胃或十二指肠进入胆道系统。最重要的次要结局是早期和晚期临床成功率，均与胆红素血液水平的降低相关。
2011 年 1 月至 2017 年 11 月期间，共纳入 36 例患者。技术成功率为 91.6%。早期或晚期临床成功率为 75.8%。ECOG 表现状态评分低于 3 与临床成功率相关。30.3%的患者出现不良事件。
EUS-BD 是一种有效且安全的治疗方法。
