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Endoscopic ultrasonography‐guided biliary and pancreatic duct interventions
Author(s) -
Dhir Vinay,
Isayama Hiroyuki,
Itoi Takao,
Almadi Majid,
Siripun Aroon,
Teoh Anthony Y. B.,
Ho Khek Yu
Publication year - 2017
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12818
Subject(s) - medicine , major duodenal papilla , endoscopic retrograde cholangiopancreatography , percutaneous , endoscopic ultrasonography , radiology , pancreatic duct , pancreatitis , gallbladder , biliary drainage , drainage , bile duct , stent , general surgery , surgery , endoscopy , ecology , biology
Drainage of obstructed bile duct and pancreatic duct under endoscopic ultrasonography (EUS) guidance has evolved into viable techniques suitable for patients with failed endoscopic retrograde cholangiopancreatography (ERCP) and/or altered surgical anatomy. One of the major advantages of EUS guidance is the possibility of multiple access points depending upon patient and ductal anatomy. Unlike ERCP, an approachable papilla is not a requisite for successful EUS‐guided biliary or pancreatic ductal drainage. Moreover, as the access is away from the papilla, there is the possibility of reduced pancreatitis. A variety of procedures have become available for EUS‐guided drainage, and it is important to develop standard terminology and procedural details. EUS‐specific stents, including lumen‐apposing metal stents have recently become available, and are likely to impact the outcomes of these procedures. Available data show a high success rate and acceptable adverse event rate for EUS‐guided biliary drainage. Success rate appears to be low for pancreatic duct drainage because of a variety of reasons. Outcomes of EUS‐guided biliary drainage appear equivalent to percutaneous drainage and ERCP. EUS‐guided gallbladder drainage appears promising for patients requiring gallbladder drainage but unfit for surgery. Further large controlled studies are needed to evaluate the exact role of these procedures.