Endoscopic ultrasound-guided biliary drainage and gastrointestinal anastomoses: the journey from promising innovations to standard of care

Το τεκμήριο παρέχεται από τον φορέα :
Ελληνική Γαστροεντερολογική Εταιρία   

Αποθετήριο :
Annals of Gastroenterology   

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Endoscopic ultrasound-guided biliary drainage and gastrointestinal anastomoses: the journey from promising innovations to standard of care (EN)

Arcidiacono, Paolo Giorgio
van Wanrooij, Roy L.J.
Gkolfakis, Paraskevas
Rizzatti, Gianenrico
Larghi, Alberto
Bronswijk, Michiel
Vanella, Giuseppe
Dell'Anna, Giuseppe
van der Merwe, Schalk

info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion

2022-08-30


Biliary obstruction (BO) and gastric outlet obstruction (GOO) are frequent complications of pancreatobiliary and gastroduodenal neoplasia, which can severely impact oncological outcomes, patient survival and quality of life. Although endoscopic retrograde cholangiopancreatography (ERCP) remains the gold standard for biliary drainage, this may fail or be unfeasible because of duodenal/papillary infiltration or surgically-altered anatomy. Percutaneous transhepatic biliary drainage (PTBD) has been the standard rescue therapy in this setting, but is burdened by high morbidity and reduced quality of life. As for GOO, surgical gastroenterostomy and enteral stenting are limited by invasiveness and suboptimal long-term outcomes, respectively. Endoscopic ultrasound (EUS) has evolved from a diagnostic to a therapeutic modality, providing a safe and effective alternative for draining the pancreatobiliary tract into the stomach or duodenum. EUS-guided biliary drainage (EUS-BD) has already demonstrated similar efficacy, greater safety and fewer reinterventions compared to PTBD, and can be performed in the same session after ERCP failure. Further development of lumen apposing metal stents has paved the way towards the creation of EUSguided anastomoses. EUS-guided gastroenterostomy (EUS-GE) is nowadays increasingly used to treat GOO, combining the minimal invasiveness of endoscopy with surgical-range efficacy. This review summarizes the technical details, current evidence and society recommendations contributing to EUS-BD and EUS-GE gaining ground in everyday practice or tertiary referral centers and becoming crucial in improving the multidisciplinary management of cancerrelated symptoms. Keywords Endoscopic ultrasound, gastric outlet obstruction, hepaticogastrostomy, choledochoduodenostomy, gastroenterostomy Ann Gastroenterol 2022; 35 (5): 441-451 (EN)


Αγγλική γλώσσα

Hellenic Society of Gastroenterology (EN)


1792-7463
1108-7471
Annals of Gastroenterology; Volume 35, No 5 (2022); 441 (EN)

Copyright (c) 2022 Annals of Gastroenterology (EN)




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