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Endoscopy 2011; 43(5): 438-441
DOI: 10.1055/s-0030-1256097
Case report/series

© 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

C.  Fabbri1 , C.  Luigiano1 , L.  Fuccio2 , A.  M.  Polifemo1 , F.  Ferrara1 , S.  Ghersi1 , M.  Bassi1 , P.  Billi1 , A.  Maimone1 , V.  Cennamo2 , M.  Masetti3 , E.  Jovine3 , N.  D’Imperio1
  • 1Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
  • 2Department of Internal Medicine and Gastroenterology, University of Bologna, Italy
  • 3Unit of General Surgery, AUSL Bologna Maggiore Hospital, Bologna, Italy
Further Information

Publication History

submitted 19 July 2010

accepted after revision 11 October 2010

Publication Date:
26 January 2011 (online)

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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