Endoscopic Ultrasound-Guided Biliary Drainage Using Self-Expandable Metal Stent for Malignant Biliary Obstruction
Table 2
Technique details and follow-up results of EUS-BD.
Outcomes
EUS-guided biliary drainage (n = 24)
Successful biliary access, n (%)
24 (100)
Technique success, n (%)
23 (95.8)
Clinical success, n (%)
23 (100)
Type of procedure, n (%)
EUS-HGS
3 (13)
EUS-CDS
17 (74)
EUS-RV
3 (13)
Obstruction site of bile duct, n (%)
Hepatic hilum
4 (16.7)
Distal bile duct
20 (83.3)
Maximum bile duct diameter, mean (SD), mm
Patients with distal biliary obstruction
17.4 (3.7)a
Patients with proximal biliary obstruction
10.0 (2.2)
Procedure time, mean (SD), min
40.1 (11.1)
EUS-HGS
39.3 (5.0)b
EUS-CDS
35.9 (5.0)
EUS-RV
64.7 (9.1)c
Stent size (diameter and length), n (%)
FCSEMS
20 (87)
8 mm × 6 cm
2 (8.7)
10 mm × 4 cm
2 (8.7)
10 mm × 6 cm
11 (47.8)
10 mm × 8 cm
5 (21.7)
UCSEMS
3 (13)
10 mm × 6 cm
3 (13)
Follow-up period, mean (SD), months
6.4 (3.1)
Stent patency, mean (SD), months
5.8 (2.2)
Complications, n (%)
3 (13)
Cholangitis
1 (4.3)
Bleeding
2 (8.7)
Complication rate, % (n/m)
First 2 years
37.5 (3/8)
Last 2 years
0 (0/15)d
Reintervention, n (%)
Stent occlusion
2 (8.7)
Prognosis, n (%)
Dead
22 (91.7)
Alive
2 (8.3)
EUS-RV: endoscopic ultrasound-guided rendezvous technique; EUS-HGS: endoscopic ultrasound-guided hepaticogastrostomy; EUS-CDS: endoscopic ultrasound-guided choledochoduodenostomy. aThe mean maximum bile duct diameter of those patients with distal biliary obstruction before puncture (17.4 ± 3.7 mm) was significantly larger than that of patients with proximal biliary obstruction (10.0 ± 2.2 mm) (). bThere was no significant difference in mean procedure time between the CDS group and HGS group (). cMean procedure time for the CDS group or HGS group was significantly shorter than that for the RV group ( for both comparisons). dThe complication rate in the first 2 years (37.5%, 3/8) was higher than that for the last two years (0%, 0/15) ().
