Endoscopic Ultrasound-Guided Biliary Drainage for Benign Biliary Diseases
Although endoscopic retrograde cholangiopancreatography (ERCP) is the first-line treatment for benign biliary diseases, this procedure is technically difficult in some conditions such as a surgically altered anatomy and gastric outlet obstruction. After a failed ERCP, a surgical or a percutaneous ap...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Gastrointestinal Endoscopy
2019-05-01
|
| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2018-188.pdf |
| _version_ | 1827802578923028480 |
|---|---|
| author | Yousuke Nakai Hirofumi Kogure Hiroyuki Isayama Kazuhiko Koike |
| author_facet | Yousuke Nakai Hirofumi Kogure Hiroyuki Isayama Kazuhiko Koike |
| author_sort | Yousuke Nakai |
| collection | DOAJ |
| description | Although endoscopic retrograde cholangiopancreatography (ERCP) is the first-line treatment for benign biliary diseases, this procedure is technically difficult in some conditions such as a surgically altered anatomy and gastric outlet obstruction. After a failed ERCP, a surgical or a percutaneous approach is selected as a rescue procedure; however, various endoscopic ultrasound (EUS)-guided interventions are increasingly utilized in pancreatobiliary diseases, including EUS-guided rendezvous for failed biliary cannulation, EUS-guided antegrade treatment for stone management, and EUS-guided hepaticogastrostomy for anastomotic strictures in patients with a surgically altered anatomy. There are some technical hurdles in EUS-guided interventions for benign biliary diseases owing to the difficulty in puncturing a relatively small bile duct and in subsequent guidewire manipulation, as well as the lack of dedicated devices. A recent major advancement in this field is the introduction of a 2-step approach, in which EUS-guided drainage is placed in the first session and antegrade treatment is performed in subsequent sessions. This approach allows the use of various techniques such as mechanical lithotripsy and cholangioscopy without a risk of bile leak. In summary, EUS-guided interventions are among the treatment options for benign biliary diseases; however, standardization of the procedure and development of a treatment algorithm are needed. |
| first_indexed | 2024-03-11T20:42:02Z |
| format | Article |
| id | doaj.art-0fa3af72a9e74b04bed2dbd62287e530 |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-11T20:42:02Z |
| publishDate | 2019-05-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-0fa3af72a9e74b04bed2dbd62287e5302023-10-02T01:12:54ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432019-05-0152321221910.5946/ce.2018.1887201Endoscopic Ultrasound-Guided Biliary Drainage for Benign Biliary DiseasesYousuke Nakai0Hirofumi Kogure1Hiroyuki Isayama2Kazuhiko Koike3 Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanAlthough endoscopic retrograde cholangiopancreatography (ERCP) is the first-line treatment for benign biliary diseases, this procedure is technically difficult in some conditions such as a surgically altered anatomy and gastric outlet obstruction. After a failed ERCP, a surgical or a percutaneous approach is selected as a rescue procedure; however, various endoscopic ultrasound (EUS)-guided interventions are increasingly utilized in pancreatobiliary diseases, including EUS-guided rendezvous for failed biliary cannulation, EUS-guided antegrade treatment for stone management, and EUS-guided hepaticogastrostomy for anastomotic strictures in patients with a surgically altered anatomy. There are some technical hurdles in EUS-guided interventions for benign biliary diseases owing to the difficulty in puncturing a relatively small bile duct and in subsequent guidewire manipulation, as well as the lack of dedicated devices. A recent major advancement in this field is the introduction of a 2-step approach, in which EUS-guided drainage is placed in the first session and antegrade treatment is performed in subsequent sessions. This approach allows the use of various techniques such as mechanical lithotripsy and cholangioscopy without a risk of bile leak. In summary, EUS-guided interventions are among the treatment options for benign biliary diseases; however, standardization of the procedure and development of a treatment algorithm are needed.http://www.e-ce.org/upload/pdf/ce-2018-188.pdfBenign biliary diseasesBiliary drainageCholangioscopyEndoscopic ultrasound |
| spellingShingle | Yousuke Nakai Hirofumi Kogure Hiroyuki Isayama Kazuhiko Koike Endoscopic Ultrasound-Guided Biliary Drainage for Benign Biliary Diseases Clinical Endoscopy Benign biliary diseases Biliary drainage Cholangioscopy Endoscopic ultrasound |
| title | Endoscopic Ultrasound-Guided Biliary Drainage for Benign Biliary Diseases |
| title_full | Endoscopic Ultrasound-Guided Biliary Drainage for Benign Biliary Diseases |
| title_fullStr | Endoscopic Ultrasound-Guided Biliary Drainage for Benign Biliary Diseases |
| title_full_unstemmed | Endoscopic Ultrasound-Guided Biliary Drainage for Benign Biliary Diseases |
| title_short | Endoscopic Ultrasound-Guided Biliary Drainage for Benign Biliary Diseases |
| title_sort | endoscopic ultrasound guided biliary drainage for benign biliary diseases |
| topic | Benign biliary diseases Biliary drainage Cholangioscopy Endoscopic ultrasound |
| url | http://www.e-ce.org/upload/pdf/ce-2018-188.pdf |
| work_keys_str_mv | AT yousukenakai endoscopicultrasoundguidedbiliarydrainageforbenignbiliarydiseases AT hirofumikogure endoscopicultrasoundguidedbiliarydrainageforbenignbiliarydiseases AT hiroyukiisayama endoscopicultrasoundguidedbiliarydrainageforbenignbiliarydiseases AT kazuhikokoike endoscopicultrasoundguidedbiliarydrainageforbenignbiliarydiseases |