CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(07): E861-E868
DOI: 10.1055/a-1161-8488
Original article

Outcomes of EUS-guided choledochoduodenostomy as primary drainage for distal biliary obstruction with covered self-expandable metallic stents

Naosuke Kuraoka
1  Department of Gastroenterology, Aichi Cancer Center Hospital
2  Department of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University
,
Kazuo Hara
1  Department of Gastroenterology, Aichi Cancer Center Hospital
,
Nozomi Okuno
1  Department of Gastroenterology, Aichi Cancer Center Hospital
,
Takamichi Kuwahara
1  Department of Gastroenterology, Aichi Cancer Center Hospital
,
Nobumasa Mizuno
1  Department of Gastroenterology, Aichi Cancer Center Hospital
,
Yasuhiro Shimizu
3  Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
,
Yasumasa Niwa
4  Department of Endoscopy, Aichi Cancer Center Hospital
,
Shuji Terai
2  Department of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University
› Author Affiliations

Abstract

Background and study aims Endoscopic ultrasonography-guided choledochoduodenostomy (EUS-CDS) is an alternative therapy for percutaneous transhepatic biliary drainage. Outcomes of EUS-CDS for distal biliary tract obstruction with a covered self-expandable metallic stent (SEMS) as a primary drainage technique are unclear because there are few relevant reports. This study aimed to determine outcomes in patients undergoing EUS-CDS using SEMS as the primary drainage technique for malignant distal biliary duct obstruction.

Patients and methods This retrospective study was conducted at Aichi Cancer Center Hospital, from January 2010 to July 2018, using data from our database.

Results EUS-CDS was performed as a primary drainage technique for 92 patients. The technical success rate was 92.8 %, and the clinical success rate was 91.6 %. The overall incidence of adverse events was 15.7 %. The median stent patency time for the EUS-CDS was 396 days. Nineteen patients required re-intervention because of cholangitis or jaundice.

Conclusion EUS-CDS as a primary drainage technique using SEMS has high technical and clinical success rates. It should be considered an effective drainage method with respect to long-term stent patency, low re-intervention rates, and absence of severe complications.



Publication History

Received: 16 October 2019

Accepted: 25 February 2020

Publication Date:
16 June 2020 (online)

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