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EUS-guided versus percutaneous biliary access in patients with obstructive jaundice due to gastric cancer.
Dig Liver Dis. 2019 02; 51(2):247-252.DL

Abstract

BACKGROUND

Gastric cancer is sometimes complicated by obstructive jaundice. However, ERCP may be challenging in patients who have advanced gastric cancer, or recurrent gastric cancer after surgical resection that is complicated by obstructive jaundice. In such cases, percutaneous transhepatic biliary drainage (PTBD) is considered. Recently, EUS-guided biliary drainage (EUS-BD) has been developed. We conducted a retrospective study to compare the efficacy of EUS-BD and PTBD in patients with obstructive jaundice due to gastric cancer.

METHODS

Patients with gastric cancer complicated with obstructive jaundice who were contraindicated for standard ERCP were enrolled.

RESULTS

A total of 47 consecutive patients were enrolled during the study period. The technical success rates of PTBD and EUS-BD were 88.9% (16/18) and 96.7% (29/30), respectively (P = 0.64). The stent patency period, including patient death was equivalent between the two groups (EUS-BD vs. PTBD: 188.4 days vs. 200.9 days, P = 0.974). Time to stent dysfunction in the EUS-BD group (391.1 days) was not significantly different as compared to that in the PTBD group (398.1 days) (P = 0.78). Adverse events were relatively severe in the PTBD group.

CONCLUSIONS

Given the relative severity of adverse events in the PTBD group, EUS-BD might be the procedure of choice for gastric cancer patients with contraindications by inability to perform ERCP.

Authors+Show Affiliations

2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan. Electronic address: oguratakeshi0411@yahoo.co.jp.2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30327252

Citation

Ogura, Takeshi, et al. "EUS-guided Versus Percutaneous Biliary Access in Patients With Obstructive Jaundice Due to Gastric Cancer." Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, vol. 51, no. 2, 2019, pp. 247-252.
Ogura T, Okuda A, Miyano A, et al. EUS-guided versus percutaneous biliary access in patients with obstructive jaundice due to gastric cancer. Dig Liver Dis. 2019;51(2):247-252.
Ogura, T., Okuda, A., Miyano, A., Imanishi, M., Nishioka, N., Yamada, M., Yamda, T., Kamiyama, R., Masuda, D., & Higuchi, K. (2019). EUS-guided versus percutaneous biliary access in patients with obstructive jaundice due to gastric cancer. Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 51(2), 247-252. https://doi.org/10.1016/j.dld.2018.09.015
Ogura T, et al. EUS-guided Versus Percutaneous Biliary Access in Patients With Obstructive Jaundice Due to Gastric Cancer. Dig Liver Dis. 2019;51(2):247-252. PubMed PMID: 30327252.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - EUS-guided versus percutaneous biliary access in patients with obstructive jaundice due to gastric cancer. AU - Ogura,Takeshi, AU - Okuda,Atsushi, AU - Miyano,Akira, AU - Imanishi,Miyuki, AU - Nishioka,Nobu, AU - Yamada,Masanori, AU - Yamda,Tadahiro, AU - Kamiyama,Rieko, AU - Masuda,Daisuke, AU - Higuchi,Kazuhide, Y1 - 2018/09/22/ PY - 2018/06/28/received PY - 2018/09/12/revised PY - 2018/09/16/accepted PY - 2018/10/18/pubmed PY - 2019/6/14/medline PY - 2018/10/18/entrez KW - EUS KW - EUS-guided biliary drainage KW - Gastric cancer KW - Percutaneous biliary drainage SP - 247 EP - 252 JF - Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver JO - Dig Liver Dis VL - 51 IS - 2 N2 - BACKGROUND: Gastric cancer is sometimes complicated by obstructive jaundice. However, ERCP may be challenging in patients who have advanced gastric cancer, or recurrent gastric cancer after surgical resection that is complicated by obstructive jaundice. In such cases, percutaneous transhepatic biliary drainage (PTBD) is considered. Recently, EUS-guided biliary drainage (EUS-BD) has been developed. We conducted a retrospective study to compare the efficacy of EUS-BD and PTBD in patients with obstructive jaundice due to gastric cancer. METHODS: Patients with gastric cancer complicated with obstructive jaundice who were contraindicated for standard ERCP were enrolled. RESULTS: A total of 47 consecutive patients were enrolled during the study period. The technical success rates of PTBD and EUS-BD were 88.9% (16/18) and 96.7% (29/30), respectively (P = 0.64). The stent patency period, including patient death was equivalent between the two groups (EUS-BD vs. PTBD: 188.4 days vs. 200.9 days, P = 0.974). Time to stent dysfunction in the EUS-BD group (391.1 days) was not significantly different as compared to that in the PTBD group (398.1 days) (P = 0.78). Adverse events were relatively severe in the PTBD group. CONCLUSIONS: Given the relative severity of adverse events in the PTBD group, EUS-BD might be the procedure of choice for gastric cancer patients with contraindications by inability to perform ERCP. SN - 1878-3562 UR - https://www.unboundmedicine.com/medline/citation/30327252/EUS_guided_versus_percutaneous_biliary_access_in_patients_with_obstructive_jaundice_due_to_gastric_cancer_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1590-8658(18)30985-X DB - PRIME DP - Unbound Medicine ER -