Abstract
Background and study aims: Endoscopic retro-grade cholangiography (ERC) with stenting is the procedure of choice for biliary decompression in patients with obstructive jaundice. In cases where biliary access cannot be achieved, interventional endoscopic ultrasound-guided cholangiography (IEUC) has become an alternative to percutaneous transhepatic cholangiography (PTC). Patients and methods: We report on 5years of experience in patients who underwent IEUC after -failed endoscopic retrograde cholangiopancreatography (ERCP). Endoscopic ultrasound-guided access to the targeted biliary duct was attempted with one of two approaches: transgastric-transhepatic (intrahepatic) or transenteric- transcholedochal (extrahepatic). A stent was then advanced over the wire and into the biliary tree. Results: A total of 49patients underwent IEUC: 35had biliary obstruction due to malignancy and 14had a benign etiology. The overall success rate of IEUC was 84% (41/49), with an overall complication rate of 16%. Of the 35patients who underwent the intrahepatic approach, 23 had a stent placed across the major papilla, one had a stent placed intra-ductally in the common bile duct, and three patients underwent placement of a gastrohepatic stent. Resolution of obstruction was achieved in 29patients, with a success rate of 83%. In all, 14patients underwent an extrahepatic approach. In 8/14 (57%), stent placement across the major papilla was achieved. A transenteric stent was placed in four patients. Biliary decompression was achieved in 12/14cases (86%). Based on intention-to-treat analysis, the intrahepatic approach achieved success in 29 of 40cases (73%), and the extrahepatic approach was successful in seven of nine cases (78%). There were no procedure-related deaths. Conclusion: IEUC offers a feasible alternative to PTC in patients with obstructive jaundice in whom ERC has failed.
| Original language | German |
|---|---|
| Pages (from-to) | 174-180 |
| Number of pages | 7 |
| Journal | Endoskopie Heute |
| Volume | 22 |
| Issue number | 3 |
| DOIs | |
| State | Published - Dec 1 2009 |
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All Science Journal Classification (ASJC) codes
- Surgery
- Radiology Nuclear Medicine and imaging
- Gastroenterology
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Interventionelle endoskopische ultraschall-cholangiografie : Langzeitergebnisse einer neuen alternative zur perkutanen cholangiografie. / Maranki, Jennifer; Hernandez, A. J.; Arslan, B.; Jaffan, A. A.; Angle, J. F.; Shami, V. M.; Kahaleh, M.; Schulz, H. J.
In: Endoskopie Heute, Vol. 22, No. 3, 01.12.2009, p. 174-180.Research output: Contribution to journal › Article
TY - JOUR
T1 - Interventionelle endoskopische ultraschall-cholangiografie
T2 - Langzeitergebnisse einer neuen alternative zur perkutanen cholangiografie
AU - Maranki, Jennifer
AU - Hernandez, A. J.
AU - Arslan, B.
AU - Jaffan, A. A.
AU - Angle, J. F.
AU - Shami, V. M.
AU - Kahaleh, M.
AU - Schulz, H. J.
PY - 2009/12/1
Y1 - 2009/12/1
N2 - Background and study aims: Endoscopic retro-grade cholangiography (ERC) with stenting is the procedure of choice for biliary decompression in patients with obstructive jaundice. In cases where biliary access cannot be achieved, interventional endoscopic ultrasound-guided cholangiography (IEUC) has become an alternative to percutaneous transhepatic cholangiography (PTC). Patients and methods: We report on 5years of experience in patients who underwent IEUC after -failed endoscopic retrograde cholangiopancreatography (ERCP). Endoscopic ultrasound-guided access to the targeted biliary duct was attempted with one of two approaches: transgastric-transhepatic (intrahepatic) or transenteric- transcholedochal (extrahepatic). A stent was then advanced over the wire and into the biliary tree. Results: A total of 49patients underwent IEUC: 35had biliary obstruction due to malignancy and 14had a benign etiology. The overall success rate of IEUC was 84% (41/49), with an overall complication rate of 16%. Of the 35patients who underwent the intrahepatic approach, 23 had a stent placed across the major papilla, one had a stent placed intra-ductally in the common bile duct, and three patients underwent placement of a gastrohepatic stent. Resolution of obstruction was achieved in 29patients, with a success rate of 83%. In all, 14patients underwent an extrahepatic approach. In 8/14 (57%), stent placement across the major papilla was achieved. A transenteric stent was placed in four patients. Biliary decompression was achieved in 12/14cases (86%). Based on intention-to-treat analysis, the intrahepatic approach achieved success in 29 of 40cases (73%), and the extrahepatic approach was successful in seven of nine cases (78%). There were no procedure-related deaths. Conclusion: IEUC offers a feasible alternative to PTC in patients with obstructive jaundice in whom ERC has failed.
AB - Background and study aims: Endoscopic retro-grade cholangiography (ERC) with stenting is the procedure of choice for biliary decompression in patients with obstructive jaundice. In cases where biliary access cannot be achieved, interventional endoscopic ultrasound-guided cholangiography (IEUC) has become an alternative to percutaneous transhepatic cholangiography (PTC). Patients and methods: We report on 5years of experience in patients who underwent IEUC after -failed endoscopic retrograde cholangiopancreatography (ERCP). Endoscopic ultrasound-guided access to the targeted biliary duct was attempted with one of two approaches: transgastric-transhepatic (intrahepatic) or transenteric- transcholedochal (extrahepatic). A stent was then advanced over the wire and into the biliary tree. Results: A total of 49patients underwent IEUC: 35had biliary obstruction due to malignancy and 14had a benign etiology. The overall success rate of IEUC was 84% (41/49), with an overall complication rate of 16%. Of the 35patients who underwent the intrahepatic approach, 23 had a stent placed across the major papilla, one had a stent placed intra-ductally in the common bile duct, and three patients underwent placement of a gastrohepatic stent. Resolution of obstruction was achieved in 29patients, with a success rate of 83%. In all, 14patients underwent an extrahepatic approach. In 8/14 (57%), stent placement across the major papilla was achieved. A transenteric stent was placed in four patients. Biliary decompression was achieved in 12/14cases (86%). Based on intention-to-treat analysis, the intrahepatic approach achieved success in 29 of 40cases (73%), and the extrahepatic approach was successful in seven of nine cases (78%). There were no procedure-related deaths. Conclusion: IEUC offers a feasible alternative to PTC in patients with obstructive jaundice in whom ERC has failed.
UR - http://www.scopus.com/inward/record.url?scp=77954725574&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77954725574&partnerID=8YFLogxK
U2 - 10.1055/s-0029-1224671
DO - 10.1055/s-0029-1224671
M3 - Article
AN - SCOPUS:77954725574
VL - 22
SP - 174
EP - 180
JO - Endoskopie Heute
JF - Endoskopie Heute
SN - 0933-811X
IS - 3
ER -