Endoscopy 2025; 57(S 02): S198-S199
DOI: 10.1055/s-0045-1805493
Abstracts | ESGE Days 2025
Moderated poster
EUS guided biliary drainage 03/04/2025, 12:00 – 13:00 Poster Dome 2 (P0)

Endoscopic Ultrasound (EUS)-Guided Gallbladder Drainage vs EUS-Guided Bile Duct Drainage After Failed ERCP for Malignant Biliary Obstruction: An International Multicenter Study

Authors

  • M Benedetto

    1   Humanitas Mater Domini, Castellanza, Italy

  • D Paduano

    1   Humanitas Mater Domini, Castellanza, Italy

  • D Ramai

    2   Gastroenterology and Hepatology, University of Utah Health, Salt Lake City, United States of America

  • G franchellucci

    3   Humanitas Research Hospital,Department of Gastroenterology and Hepatology, Rozzano, Italy

  • C Barbera

    4   Gastroenterologia ed Endoscopia – Ospedale Teramo, Teramo, Italy

  • A Fugazza

    5   Humanitas Research Hospital,Department of Gastroenterology and Hepatology, Rozzano, Italy, Rozzano, Italy

  • G Vanella

    6   IRCCS San Raffaele Scientific Institute, Milan, Italy

  • F Frigo

    7   Ospedale San Giovanni Bosco, Torino, Italy

  • P Arcidiacono

    8   Vita-Salute San Raffaele University, Milano, Italy

  • G De Nucci

    9   Garbagnate Milanese Hospital, Milan, Italy

  • A Anderloni

    10   Fondazione I.R.C.C.S. Policlinico San Matteo, Gastroenterology and Digestive Endoscopy Unit, Pavia, Italy

  • A Larghi

    11   Agostino Gemelli University Policlinic, Rome, Italy

  • S F Crinò

    12   University of Verona, Via San Francesco, Verona, VR, Italy, Italy

  • S Sundaram

    13   TATA MEMORIAL HOSPITAL, Parel, Mumbai, Mumbai, India

  • E Troncone

    14   Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy

  • KD C Pham

    15   Haukeland University Hospital / Health Bergen, Bergen, Norway

  • A Al-Lehibi

    16   King Saud Bin Abduaziz University-Health Science, King Fahad Medical City, Riyadh, Saudi Arabia

  • E Forti

    17   Digestive Endoscopy Unit, Ospedale Niguarda, Milano, Italy

  • C Gentile

    1   Humanitas Mater Domini, Castellanza, Italy

  • G Aragona

    18   Gastroenterology and Hepatology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy

  • G Manes

    19   Gastroenterology Unit, Rho-Garbagnate Hospital, ASST Rhodense, Milan, Italy

  • C Ko

    20   Health University Of Utah, Salt Lake City, United States of America

  • D M Francesco

    21   Campus biomedico University Hospital, Roma, Italy

  • F Auriemma

    1   Humanitas Mater Domini, Castellanza, Italy

  • F Minini

    22   Gastroenterology and Digestive Endoscopy Unit, Humanitas Research Hospital, Rozzano, Italy

  • M Fiacca

    23   Humanitas Research Hospital, Milan, Italy

  • C Federica

    24   Humanitas ma, castellanza, Italy

  • L L De

    25   Endoscopic Unit, ASST Santi Paolo e Carlo, Milan, Italy

  • A Y Teoh

    26   Prince of Wales Hospital, Hong Kong, Hong Kong

  • C Gallo

    27   ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy

  • M Mutignani

    28   ASST Great Metropolitan Niguarda, Milano, Italy

  • M Santi

    29   Azienda Ospedaliero – Universitaria di Modena, Modena, Italy

  • H Bertani

    30   Azienda Ospedaliero-Universitaria di Modena, Modena, Italy

  • G Del Vecchio Blanco

    14   Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy

  • V G Mirante

    31   AUSL Reggio Emilia, Reggio Emilia, Italy

  • E Aljahdli

    32   King Abdulaziz University Hospital, Jeddah, Saudi Arabia

  • A Alfadda

    33   Riyadh, Riyadh, Saudi Arabia

  • F Decembrino

    34   Ente Ecclesiastico-Ospedale Generale Regionale, bar, Italy

  • F Antonio

    35   Università degli studi di Foggia, Foggia, Italy

  • M Bronswijk

    36   Imeldaziekenhuis, Bonheiden, Belgium

  • S Van der Merwe

    37   University Hospital Gasthuisberg, Leuven, Belgium

  • G Fierro

    38   Rho Hospital, Rho, Italy

  • G Manes

    38   Rho Hospital, Rho, Italy

  • J D Morris

    20   Health University Of Utah, Salt Lake City, United States of America

  • B Martínez

    39   Hospital General Universitario, alican, Spain

  • S Stigliano

    40   Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy

  • J R Aparicio

    41   General University Hospital of Alicante, Alacant, Spain

  • S Lakhtakia

    42   Asian Institute of Gastroenterology, Hyderabad, India

  • A Ventra

    43   Azienda Ospedaliera Grande Ospedale Metropolitano Bianchi, Reggio Calabria, Italy

  • A Repici

    44   Humanitas Research Hospital, Rozzano, Italy

  • A Facciorusso

    45   Gastroenterology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
Further Information
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Aims Endoscopic ultrasound (EUS)–guided gallbladder (GB) drainage and EUS-guided bile duct (BD) drainage with lumen-apposing metal stents are alternative approaches to endoscopic retrograde cholangiopancreatography (ERCP). We compared EUS-GB and EUS-BD as second line therapies in the setting of failed ERCP for malignant biliary obstruction (MBO) [1] [2] [3].

Methods This was an international multicenter retrospective observational study at 28 tertiary-care centers through August 2024. Consecutive patients with MBO who underwent EUS-GB or EUS-BD as second line therapy with LAMS placement were included. Outcomes were compared using propensity score matching. Cohorts were compared using Chi-square, Mann-Whitney tests, and logistic regression.

Results Five hundred and twenty-nine patients (254 males; average age 73±12 years) underwent EUS guided drainage where 136 patients underwent EUS GB drainage, and 393 patients underwent EUS BD drainage. Most patients developed MBO from pancreatic cancer (79%). AXIOS stents were used in most cases (91%) compared to SPAXUS (9%). Overall, technical success was reported in 96% of cases and clinical success in 87% of cases. After 1-to-1 propensity score matching, 224 patients were selected (112 per group). EUS-GB showed higher technical success compared to EUS-BD (97% vs 92%, P=0.045). However, EUS-GB showed lower clinical success compared to EUS-BD (74% vs 86%, P=0.030). No statistical differences were reported in adverse events for EUS-GB and EUS-BD including bleeding (6% vs 3%, P=0.196), perforation (0% vs 2%, P=0.155), stent occlusion (5% vs 4%, P=0.528), stent migration (2% vs 1%, P=0.561), and acute pancreatitis (2% vs 0%, P=0.155), respectively. Stent type was not associated with technical success (AXIOS 94% vs SPAXUS 94%, P=0.983) or clinical success (AXIOS 78% vs SPAXUS 88%, P=0.188). On univariate analysis, EUS-BD was not a significant predictor of technical success (P=0.059) but had higher odds of clinical success compared to EUS-GD (OR=2.10, 95% CL 1.07-4.13, P=0.032). univariate analysis.

Conclusions In patients with MBO, EUS-GB and EUS-BD are reasonable therapeutic alternatives in the setting of failed ERCP. However, EUS-BD may offer higher clinical success when compared to EUS-GB.



Publication History

Article published online:
27 March 2025

© 2025. European Society of Gastrointestinal Endoscopy. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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