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DOI: 10.1055/s-0030-1256097
© Georg Thieme Verlag KG Stuttgart · New York
EUS-guided biliary drainage with placement of a new partially covered biliary stent for palliation of malignant biliary obstruction: a case series
Publication History
submitted 19 July 2010
accepted after revision 11 October 2010
Publication Date:
26 January 2011 (online)
![](https://www.thieme-connect.de/media/endoscopy/201105/lookinside/thumbnails/10.1055-s-0030-1256097-1.jpg)
Endoscopic ultrasonography-guided biliary drainage (EUS-BD) has been developed as an alternative drainage technique in patients with obstructive jaundice where endoscopic retrograde cholangiopancreatography (ERCP) has failed. Between July 2008 and December 2009, 16 patients (9 men; median age 79 years) with biliopancreatic malignancy, who were candidates for alternative techniques of biliary decompression because ERCP had been unsuccessful, underwent EUS-BD with placement of a transmural or transpapillary partially covered nitinol self-expandable metal stent (SEMS). EUS-assisted cholangiography was successful in all patients, with definition of the relevant anatomy, but biliary drainage was successfully performed in only 12 (75 %) of the 16 patients (9 choledochoduodenostomies with SEMS placement and 3 biliary rendezvous procedures with papillary SEMS placement), with regression of the cholestasis. No major complications and no procedure-related deaths occurred. There was one case of pneumoperitoneum which was managed conservatively. The median follow-up was 170 days. During the follow-up, eight patients of the 12 patients in whom biliary draining was successful died; four are currently alive. None of the patients required endoscopic reintervention. This series demonstrated that EUS-BD with a partially covered SEMS has a high rate of clinical success and low complication rates, and could represent an alternative choice for biliary decompression.
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C. FabbriMD
Unit of Gastroenterology and Digestive Endoscopy
AUSL Bologna Bellaria-Maggiore Hospital
Largo Nigrisoli 2 40135 Bologna
Italy
Fax: +39-051-6225247
Email: carlo.fabbri@ausl.bologna.it