Voiosu Theodor Alexandru, Rimbaș Mihai, Larghi Alberto
Carol Davila Faculty of Medicine, 021155 Bucharest, Romania.
Gastroenterology Department, Colentina Clinical Hospital, 020125 Bucharest, Romania.
Cancers (Basel). 2023 May 12;15(10):2730. doi: 10.3390/cancers15102730.
Malignant biliary obstruction (DMBO) has been traditionally managed by endoscopic retrograde cholangiopancreatography (ERCP). In the case of ERC failure, percutaneous transhepatic biliary drainage (PT-BD) has been widely utilized as a salvage procedure. However, over the last decade, endoscopic ultrasound-guided biliary drainage (EUS-BD) has gained increasing popularity, especially after the advent of electrocautery-enhanced lumen apposing metal stent devices (EC-LAMSs) which enable a one-step procedure, granting prevention of biliary leakage and minimizing occurrence of adverse events (AEs). In parallel, increasing evidence suggests a possible role of EUS-BD in the management of DMBO as a primary palliative drainage modality. In the current paper, we aim to review all the available evidence on the role of EUS-BD performed with EC-LAMSs and discuss salient technical aspects of this type of procedure.
恶性胆管梗阻（DMBO）传统上通过内镜逆行胰胆管造影术（ERCP）进行处理。在内镜逆行胰胆管造影术失败的情况下，经皮经肝胆道引流术（PT-BD）已被广泛用作挽救性手术。然而，在过去十年中，内镜超声引导下胆道引流术（EUS-BD）越来越受欢迎，尤其是在电灼增强管腔贴合金属支架装置（EC-LAMSs）出现之后，该装置能够实现一步手术，预防胆漏并将不良事件（AEs）的发生率降至最低。与此同时，越来越多的证据表明，EUS-BD作为一种主要的姑息性引流方式，在DMBO的治疗中可能发挥作用。在本文中，我们旨在回顾所有关于使用EC-LAMSs进行EUS-BD作用的现有证据，并讨论此类手术的突出技术方面。
