Abstract
Background and study aims Endoscopic ultrasound-guided biliary drainage (EUS-BD) is a widely used alternative
to endoscopic retrograde cholangiopancreatography (ERCP) when ERCP is unsuccessful
or there are contraindications such as duodenal stenosis or postsurgical intestinal
reconstruction. Therefore, we retrospectively investigated the therapeutic outcomes
of EUS-BD in a medium-sized hospital.
Patients and methods We included 31 consecutive patients who underwent EUS-BD at the Kitasato University
Medical Center between April 2018 and October 2021. Patient characteristics, technical
and clinical success rates, stent patency, adverse events (AEs), and procedure time
were analyzed.
Results Of the 31 patients included in this study, one underwent endoscopic ultrasound-guided
choledochoduodenostomy (EUS-CDS) and 30 underwent endoscopic ultrasound-guided hepaticoenterostomy
(EUS-HES). The technical success rates were 100 % for EUS-CDS and 96.8 % for EUS-HES
because EUS-HES was unsuccessful in one patient who then underwent EUS-CDS as an alternative
treatment. The clinical success rates were 100 % for EUS-CDS and 96.7% for EUS-HES. The
median follow-up period was 84 days (range: 14–483 days). Zero and 5 (16.6 %) patients
who underwent EUS-CDS and EUS, respectively had stent dysfunction. The median stent
patency (stent dysfunction and death) for EUS-HES was 124 days. AEs were observed
in only two patients (6.7 %) who underwent EUS-HES.
Conclusions EUS-BD is now more widely used than before, and advances in the devices used have
enabled the procedure to be performed more safely. Our results suggest that this introduction
in medium-sized hospitals can be conducted safely.
