EUS-guided biliary drainage or enteroscopy-assisted ERCP in patients with surgical anatomy and biliary obstruction: an international comparative study

• Published in: Endoscopy International Open 2016-12, Vol.4 (12), p.E1322-E1327
• Main Authors: Khashab, Mouen A., El Zein, Mohamad H., Sharzehi, Kaveh, Marson, Fernando P., Haluszka, Oleh, Small, Aaron J., Nakai, Yousuke, Park, Do Hyun, Kunda, Rastislav, Teoh, Anthony Y., Peñas, Irene, Perez-Miranda, Manuel, Kumbhari, Vivek, Van der Merwe, Schalk, Artifon, Everson L., Ross, Andrew S.
• Format: Article
• Language: English
• Subjects: Original article
• ISSN: 2364-3722; 2196-9736
• DOI: 10.1055/s-0042-110790

Background and study aims: How enteroscopy-assisted ERCP (e-ERCP) and endoscopic ultrasound-guided biliary drainage (EUS-BD) compare in patients with surgically altered upper gastrointestinal anatomy is currently unknown. The aims of this study were to compare efficacy and safety of both techniques and study predictors of these outcomes. Patients and methods: This was an international, multicenter comparative cohort study at 10 tertiary centers. Outcomes data included technical success (biliary access with cholangiography and stent placement [when indicated]), clinical success (resolution of biliary obstruction) and adverse events (AEs) (graded according to the ASGE lexicon). Results: A total of 98 patients underwent EUS-BD (n = 49) or e-ERCP (n = 49). Technical success was achieved in 48 (98 %) patients in the EUS-BD group as compared to 32 (65.3 %) patients in the e-ERCP group (OR 12.48, P  = 0.001). Clinical success was attained in 88 % of patients in EUS-BD group as compared to 59.1 % in the e-ERCP group (OR 2.83, P  = 0.03). Procedural time was significantly shorter in the EUS-BD group (55 min vs 95 min, P