Endoscopic ultrasound-guided biliary drainage with placement of a fully covered metal stent for malignant biliary obstruction

作     者：Tae Hyeon Kim Seong Hun Kim Hyo Jeong Oh Young Woo Sohn Seung Ok Lee 

作者机构：Department of Internal MedicineSchool of MedicineWonkwang UniversityIksanChonbuk 570-749 South Korea Department of Internal MedicineChonbuk National University Medical School and HospitalJeonjuChonbuk 561-712South Korea Department of Internal MedicineSchool of MedicineWonkwang UniversitySanbon Gyounggi 570-749South Korea 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2012年第18卷第20期

页      面：2526-2532页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Supported by Institute of Wonkwang Medical Science in 2011 

主　　题：Endoscopic ultrasound-guided Biliary drainage Metal stent Biliary obstruction 

摘      要：AIM:To determine the utility of endoscopic ultrasoundguided biliary drainage(EUS-BD)with a fully covered self-expandable metal stent for managing malignant biliary stricture. METHODS:We collected data from 13 patients who presented with malignant biliary obstruction and underwent EUS-BD with a nitinol fully covered selfexpandable metal stent when endoscopic retrograde cholangiopancreatography(ERCP)***-guided choledochoduodenostomy(EUS-CD)and EUS-guided hepaticogastrostomy(EUS-HG)was performed in 9 patients and 4 patients,respectively. RESULTS:The technical and functional success rate was 92.3%(12/13)and 91.7%(11/12),respectively. Using an intrahepatic approach(EUS-HG,n=4),there was mild peritonitis(n=1)and migration of the metal stent to the stomach(n=1).With an extrahepatic approach(EUS-CD,n=10),there was pneumoperitoneum(n=2),migration(n=2),and mild peritonitis (n=1).All patients were managed conservatively with *** follow-up(range,1-12 mo),there was re-intervention(4/13 cases,30.7%)necessitated by stent migration(n=2)and stent occlusion(n=2). CONCLUSION:EUS-BD with a nitinol fully covered self-expandable metal stent may be a feasible and effective treatment option in patients with malignant biliary obstruction when ERCP fails.