Endoscopic ultrasound-guided antegrade treatment of bile duct stone in patients with surgically altered anatomy: a multicenter retrospective cohort study

被引：85
作者：
Iwashita, Takuji [1 ]
Nakai, Yousuke [2 ]
Hara, Kazuo [3 ]
Isayama, Hiroyuki [2 ]
Itoi, Takao [4 ]
Park, Do Hyun [5 ]
机构：
[1] Gifu Univ Hosp, Dept Internal Med 1, 1-1 Yanagido, Gifu 5011194, Japan
[2] Univ Tokyo, Dept Gastroenterol, Grad Sch Med, Tokyo, Japan
[3] Aichi Canc Ctr Hosp, Dept Gastroenterol, Aichi, Japan
[4] Tokyo Med Univ, Dept Gastroenterol & Hepatol, Tokyo 1608402, Japan
[5] Univ Ulsan, Div Gastroenterol, Dept Internal Med, Asan Med Ctr,Coll Med, Seoul, South Korea
来源：
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES | 2016年 / 23卷 / 04期
关键词：
Antegrade; Bile duct stone; Endoscopic papillary balloon dilation; Endoscopic ultrasound; Surgically altered anatomy; SINGLE-BALLOON ENTEROSCOPE; METAL STENT; MALIGNANT BILIARY; OBSTRUCTION; ANTEROGRADE; PLACEMENT; DRAINAGE; ANASTOMOSIS; REMOVAL; ERCP;
D O I：
10.1002/jhbp.329
中图分类号：
R57 [消化系及腹部疾病];
学科分类号：
摘要：
BackgroundEndoscopic retrograde cholangiopancreatography (ERCP) for management of bile duct stone (BDS) in patients with surgically altered anatomy is challenging even when applying enteroscopy. Endoscopic ultrasound-guided antegrade treatments (EUS-AG) for BDS have been developed but have not been well studied yet. The aim of the present study was to evaluate the feasibility and safety of EUS-AG for BDS in patients with surgically altered anatomy as a multicenter retrospective cohort study. MethodsA retrospective database analysis was performed to identify patients with surgically altered anatomy who underwent EUS-AG for the management of BDS at four academic care centers. Basic characteristics of the patients and details of the procedures were determined and the success rates and adverse event rates were evaluated. ResultsEUS-AG for BDS was attempted in 29 patients. Successful BDS removal was achieved in 72% (21/29) of patients. Reasons for failed EUS-AG were unsuccessful bile duct puncture in six, unsuccessful guidewire manipulation in one, and unsuccessful stone removal using a retrieval balloon in one. Adverse events occurred in five (17%) but were successfully managed conservatively. ConclusionEUS-AG for BDS is a feasible and safe alternative in patients with surgically altered anatomy, although further evaluation and development of dedicated devices are needed.
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页码：227 / 233
页数：7
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