Technical tips of endoscopic ultrasound-guided choledochoduodenostomy |
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Authors: | Takeshi Ogura Kazuhide Higuchi |
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Institution: | Takeshi Ogura, Kazuhide Higuchi, Second Department of Internal Medicine, Osaka Medical College, Osaka 569-8686, Japan |
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Abstract: | Endoscopic ultrasound(EUS) is clinically useful not only as a diagnostic tool during EUS-guided fine needle aspiration,but also during interventional EUS.EUS-guided biliary drainage has been developed and performed by experienced endoscopists.EUS-guided choledocoduodenostomy(EUS-CDS) is relatively well established as an alternative biliary drainage method for biliary decompression in patients with biliary obstruction.The reported technical success rate of EUS-CDS ranges from 50% to 100%,and the clinical success rate ranges from 92% to 100%.Further,the over-all technicalsuccess rate was 93%,and clinical success rate was 98%.Based on the currently available literature,the overall adverse event rate for EUS-CDS is 16%.The data on the cumulative technical and clinical success rate for EUS-CDS is promising.However,EUS-CDS can still lead to several problems,so techniques or devices that are more feasible and safe need to be established.EUS-CDS has the potential to become a first-line biliary drainage procedure,although standardizing the technique in multicenter clinical trials and comparisons with endoscopic biliary drainage by randomized clinical trials are still needed. |
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Keywords: | Endoscopic ultrasound Endoscopic ultrasound-guided choledochoduodenostomy Endoscopic ultrasound-guided biliary drainage Percutaneous transhepatic biliary drainage |
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