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Interventional EUS: Bile Duct and Gallbladder

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Gastrointestinal Interventional Endoscopy

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Abstract

In the last decade, EUS-guided biliary drainage (EUS-BD) has emerged as an alternative approach for drainage of the bile ducts. The approach allows internal drainage of bile with either a transpapillary or transmural technique depending on the etiology and level of obstruction avoiding percutaneous tubes or surgery. Similarly, EUS-guided gallbladder drainage (EGBD) is also gaining popularity as an endoscopic alternative to percutaneous drainage of the gallbladder. In this chapter, we will provide an overview on the current developments in EUS-BD and EGBD. The indications, techniques, outcomes, and risk of adverse events of both the techniques are discussed.

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References

  1. Moss AC, Morris E, Mac Mathuna P. Palliative biliary stents for obstructing pancreatic carcinoma. Cochrane Database Syst Rev. 2006:CD004200.

    Google Scholar 

  2. Lai EC, Mok FP, Tan ES, et al. Endoscopic biliary drainage for severe acute cholangitis. N Engl J Med. 1992;326:1582–6.

    Article  CAS  PubMed  Google Scholar 

  3. Speer AG, Cotton PB, Russell RC, et al. Randomised trial of endoscopic versus percutaneous stent insertion in malignant obstructive jaundice. Lancet. 1987;2:57–62.

    Article  CAS  PubMed  Google Scholar 

  4. van Delden OM, Lameris JS. Percutaneous drainage and stenting for palliation of malignant bile duct obstruction. Eur Radiol. 2008;18:448–56.

    Article  PubMed  Google Scholar 

  5. Zhao XQ, Dong JH, Jiang K, et al. Comparison of percutaneous transhepatic biliary drainage and endoscopic biliary drainage in the management of malignant biliary tract obstruction: a meta-analysis. Dig Endosc. 2015;27:137–45.

    Article  PubMed  Google Scholar 

  6. Baron TH, Petersen BT, Mergener K, et al. Quality indicators for endoscopic retrograde cholangiopancreatography. Am J Gastroenterol. 2006;101:892–7.

    Article  PubMed  Google Scholar 

  7. Kolla SB, Aggarwal S, Kumar A, et al. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective randomized trial. Surg Endosc. 2004;18:1323–7.

    Article  CAS  PubMed  Google Scholar 

  8. Lai PB, Kwong KH, Leung KL, et al. Randomized trial of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg. 1998;85:764–7.

    Article  CAS  PubMed  Google Scholar 

  9. Lo CM, Liu CL, Fan ST, et al. Prospective randomized study of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Ann Surg. 1998;227:461–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Johansson M, Thune A, Nelvin L, et al. Randomized clinical trial of open versus laparoscopic cholecystectomy in the treatment of acute cholecystitis. Br J Surg. 2005;92:44–9.

    Article  CAS  PubMed  Google Scholar 

  11. Teoh AY, Chong CN, Wong J, et al. Routine early laparoscopic cholecystectomy for acute cholecystitis after conclusion of a randomized controlled trial. Br J Surg. 2007;94:1128–32.

    Article  CAS  PubMed  Google Scholar 

  12. Tsuyuguchi T, Itoi T, Takada T, et al. TG13 indications and techniques for gallbladder drainage in acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci. 2013;20:81–8.

    Article  PubMed  Google Scholar 

  13. McKay A, Abulfaraj M, Lipschitz J. Short- and long-term outcomes following percutaneous cholecystostomy for acute cholecystitis in high-risk patients. Surg Endosc. 2012;26:1343–51.

    Article  PubMed  Google Scholar 

  14. Boules M, Haskins IN, Farias-Kovac M, et al. What is the fate of the cholecystostomy tube following percutaneous cholecystostomy? Surg Endosc. 2017;31:1707–12.

    Article  CAS  PubMed  Google Scholar 

  15. Lee SS, Park DH, Hwang CY, et al. EUS-guided transmural cholecystostomy as rescue management for acute cholecystitis in elderly or high-risk patients: a prospective feasibility study. Gastrointest Endosc. 2007;66:1008–12.

    Article  PubMed  Google Scholar 

  16. Jang JW, Lee SS, Park DH, et al. Feasibility and safety of EUS-guided transgastric/transduodenal gallbladder drainage with single-step placement of a modified covered self-expandable metal stent in patients unsuitable for cholecystectomy. Gastrointest Endosc. 2011;74:176–81.

    Article  PubMed  Google Scholar 

  17. Jang JW, Lee SS, Song TJ, et al. Endoscopic ultrasound-guided transmural and percutaneous transhepatic gallbladder drainage are comparable for acute cholecystitis. Gastroenterology. 2012;142:805–11.

    Article  PubMed  Google Scholar 

  18. Itoi T, Binmoeller KF, Shah J, et al. Clinical evaluation of a novel lumen-apposing metal stent for endosonography-guided pancreatic pseudocyst and gallbladder drainage (with videos). Gastrointest Endosc. 2012;75:870–6.

    Article  PubMed  Google Scholar 

  19. de la Serna-Higuera C, Perez-Miranda M, Gil-Simon P, et al. EUS-guided transenteric gallbladder drainage with a new fistula-forming, lumen-apposing metal stent. Gastrointest Endosc. 2013;77:303–8.

    Article  PubMed  Google Scholar 

  20. Moon JH, Choi HJ, Kim DC, et al. A newly designed fully covered metal stent for lumen apposition in EUS-guided drainage and access: a feasibility study (with videos). Gastrointest Endosc. 2014;79:990–5.

    Article  PubMed  Google Scholar 

  21. Choi JH, Lee SS, Choi JH, et al. Long-term outcomes after endoscopic ultrasonography-guided gallbladder drainage for acute cholecystitis. Endoscopy. 2014;46:656–61.

    Article  PubMed  Google Scholar 

  22. Law R, Grimm IS, Stavas JM, et al. Conversion of percutaneous cholecystostomy to internal transmural gallbladder drainage using an endoscopic ultrasound-guided, lumen-apposing metal stent. Clin Gastroenterol Hepatol. 2016;14:476–80.

    Article  PubMed  Google Scholar 

  23. Walter D, Teoh AY, Itoi T, et al. EUS-guided gall bladder drainage with a lumen-apposing metal stent: a prospective long-term evaluation. Gut. 2016;65:6–8.

    Article  CAS  PubMed  Google Scholar 

  24. Ge N, Sun S, Sun S, et al. Endoscopic ultrasound-assisted transmural cholecystoduodenostomy or cholecystogastrostomy as a bridge for per-oral cholecystoscopy therapy using double-flanged fully covered metal stent. BMC Gastroenterol. 2016;16:9.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  25. Kahaleh M, Perez-Miranda M, Artifon EL, et al. International collaborative study on EUS-guided gallbladder drainage: are we ready for prime time? Dig Liver Dis. 2016;48:1054–7.

    Article  PubMed  Google Scholar 

  26. Teoh AY, Serna C, Penas I, et al. Endoscopic ultrasound-guided gallbladder drainage reduces adverse events compared with percutaneous cholecystostomy in patients who are unfit for cholecystectomy. Endoscopy. 2017;49:130–8.

    PubMed  Google Scholar 

  27. Tyberg A, Saumoy M, Sequeiros EV, et al. EUS-guided versus percutaneous gallbladder drainage: isn’t it time to convert? J Clin Gastroenterol. 2016;52:79.

    Google Scholar 

  28. Irani S, Ngamruengphong S, Teoh A, et al. Similar efficacies of endoscopic ultrasound gallbladder drainage with a lumen-apposing metal stent versus percutaneous transhepatic gallbladder drainage for acute cholecystitis. Clin Gastroenterol Hepatol. 2017;15:738–45.

    Article  PubMed  Google Scholar 

  29. Choi JH, Kim HW, Lee JC, et al. Percutaneous transhepatic versus EUS-guided gallbladder drainage for malignant cystic duct obstruction. Gastrointest Endosc. 2017;85:357–64.

    Article  PubMed  Google Scholar 

  30. Kamata K, Takenaka M, Kitano M, et al. Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis: long-term outcomes after removal of a self-expandable metal stent. World J Gastroenterol. 2017;23:661–7.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Dollhopf M, Larghi A, Will U, et al. Eus-guided gallbladder drainage in patients with acute cholecystitis and high surgical risk using an electrocautery-enhanced lumen-apposing metal stent device. Gastrointest Endosc. 2017;86:636.

    Article  PubMed  Google Scholar 

  32. Chan SM, Teoh AY, Yip HC, et al. Feasibility of per-oral cholecystoscopy and advanced gallbladder interventions after EUS-guided gallbladder stenting (with video). Gastrointest Endosc. 2016;85:1225.

    Article  PubMed  Google Scholar 

  33. Itoi T, Sofuni A, Itokawa F, et al. Endoscopic ultrasonography-guided biliary drainage. J Hepatobiliary Pancreat Sci. 2010;17:611–6.

    Article  PubMed  Google Scholar 

  34. Dhir V, Isayama H, Itoi T, et al. EUS-guided biliary and pancreatic duct interventions. Dig Endosc. 2017;29:472.

    Article  PubMed  Google Scholar 

  35. Park SJ, Choi JH, Park DH, et al. Expanding indication: EUS-guided hepaticoduodenostomy for isolated right intrahepatic duct obstruction (with video). Gastrointest Endosc. 2013;78:374–80.

    Article  PubMed  Google Scholar 

  36. Ogura T, Edogawa S, Imoto A, et al. EUS-guided hepaticojejunostomy combined with antegrade stent placement. Gastrointest Endosc. 2015;81:462–3.

    Article  PubMed  Google Scholar 

  37. Liao WC, Angsuwatcharakon P, Isayama H, et al. International consensus recommendations for difficult biliary access. Gastrointest Endosc. 2017;85:295–304.

    Article  PubMed  Google Scholar 

  38. Holt BA, Hawes R, Hasan M, et al. Biliary drainage: role of EUS guidance. Gastrointest Endosc. 2016;83:160–5.

    Article  PubMed  Google Scholar 

  39. Shah JN, Marson F, Weilert F, et al. Single-operator, single-session EUS-guided anterograde cholangiopancreatography in failed ERCP or inaccessible papilla. Gastrointest Endosc. 2012;75:56–64.

    Article  PubMed  Google Scholar 

  40. Park DH, Lee TH, Paik WH, et al. Feasibility and safety of a novel dedicated device for one-step EUS-guided biliary drainage: a randomized trial. J Gastroenterol Hepatol. 2015;30:1461–6.

    Article  PubMed  Google Scholar 

  41. Bapaye A, Dubale N, Aher A. Comparison of endosonography-guided vs. percutaneous biliary stenting when papilla is inaccessible for ERCP. United European Gastroenterol J. 2013;1:285–93.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Khashab MA, Valeshabad AK, Afghani E, et al. A comparative evaluation of EUS-guided biliary drainage and percutaneous drainage in patients with distal malignant biliary obstruction and failed ERCP. Dig Dis Sci. 2015;60:557–65.

    Article  PubMed  Google Scholar 

  43. Sharaiha RZ, Kumta NA, Desai AP, et al. Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage: predictors of successful outcome in patients who fail endoscopic retrograde cholangiopancreatography. Surg Endosc. 2016;30:5500–5.

    Article  PubMed  Google Scholar 

  44. Artifon EL, Aparicio D, Paione JB, et al. Biliary drainage in patients with unresectable, malignant obstruction where ERCP fails: endoscopic ultrasonography-guided choledochoduodenostomy versus percutaneous drainage. J Clin Gastroenterol. 2012;46:768–74.

    Article  PubMed  Google Scholar 

  45. Lee TH, Choi JH, Park do H, et al. Similar efficacies of endoscopic ultrasound-guided transmural and percutaneous drainage for malignant distal biliary obstruction. Clin Gastroenterol Hepatol. 2016;14:1011–1019 e3.

    Article  PubMed  Google Scholar 

  46. Sharaiha RZ, Khan MA, Kamal F, et al. Efficacy and safety of EUS-guided biliary drainage in comparison with percutaneous biliary drainage when ERCP fails: a systematic review and meta-analysis. Gastrointest Endosc. 2017;85:904.

    Article  PubMed  Google Scholar 

  47. Park JK, Woo YS, Noh DH, et al. Efficacy of EUS-guided and ERCP-guided biliary drainage for malignant biliary obstruction: prospective randomized controlled study. Gastrointest Endosc. 2018;88:277–82.

    Article  PubMed  Google Scholar 

  48. Bang JY, Navaneethan U, Hasan M, et al. Stent placement by EUS or ERCP for primary biliary decompression in pancreatic cancer: a randomized trial (with videos). Gastrointest Endosc. 2018;88:9–17.

    Article  PubMed  Google Scholar 

  49. Paik WH, Lee TH, Park DH, et al. EUS-guided biliary drainage versus ERCP for the primary palliation of malignant biliary obstruction: a multicenter randomized clinical trial. Am J Gastroenterol. 2018;113:987–97.

    Article  PubMed  Google Scholar 

  50. Dhir V, Bhandari S, Bapat M, et al. Comparison of EUS-guided rendezvous and precut papillotomy techniques for biliary access (with videos). Gastrointest Endosc. 2012;75:354–9.

    Article  PubMed  Google Scholar 

  51. Lee A, Aditi A, Bhat YM, et al. Endoscopic ultrasound-guided biliary access versus precut papillotomy in patients with failed biliary cannulation: a retrospective study. Endoscopy. 2017;49:146–53.

    Article  PubMed  Google Scholar 

  52. Bill JG, Darcy M, Fujii-Lau LL, et al. A comparison between endoscopic ultrasound-guided rendezvous and percutaneous biliary drainage after failed ERCP for malignant distal biliary obstruction. Endosc Int Open. 2016;4:E980–5.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Artifon EL, Marson FP, Gaidhane M, et al. Hepaticogastrostomy or choledochoduodenostomy for distal malignant biliary obstruction after failed ERCP: is there any difference? Gastrointest Endosc. 2015;81:950–9.

    Article  PubMed  Google Scholar 

  54. Ogura T, Chiba Y, Masuda D, et al. Comparison of the clinical impact of endoscopic ultrasound-guided choledochoduodenostomy and hepaticogastrostomy for bile duct obstruction with duodenal obstruction. Endoscopy. 2016;48:156–63.

    Article  PubMed  Google Scholar 

  55. Khan MA, Akbar A, Baron TH, et al. Endoscopic ultrasound-guided biliary drainage: a systematic review and meta-analysis. Dig Dis Sci. 2016;61:684–703.

    Article  PubMed  Google Scholar 

  56. Khashab MA, Messallam AA, Penas I, et al. International multicenter comparative trial of transluminal EUS-guided biliary drainage via hepatogastrostomy vs. choledochoduodenostomy approaches. Endosc Int Open. 2016;4:E175–81.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Park DH, Jang JW, Lee SS, et al. EUS-guided biliary drainage with transluminal stenting after failed ERCP: predictors of adverse events and long-term results. Gastrointest Endosc. 2011;74:1276–84.

    Article  PubMed  Google Scholar 

  58. Toyota N, Takada T, Amano H, et al. Endoscopic naso-gallbladder drainage in the treatment of acute cholecystitis: alleviates inflammation and fixes operator’s aim during early laparoscopic cholecystectomy. J Hepato-Biliary-Pancreat Surg. 2006;13:80–5.

    Article  Google Scholar 

  59. Kjaer DW, Kruse A, Funch-Jensen P. Endoscopic gallbladder drainage of patients with acute cholecystitis. Endoscopy. 2007;39:304–8.

    Article  CAS  PubMed  Google Scholar 

  60. Itoi T, Sofuni A, Itokawa F, et al. Endoscopic transpapillary gallbladder drainage in patients with acute cholecystitis in whom percutaneous transhepatic approach is contraindicated or anatomically impossible (with video). Gastrointest Endosc. 2008;68:455–60.

    Article  PubMed  Google Scholar 

  61. Itoi T, Kawakami H, Katanuma A, et al. Endoscopic nasogallbladder tube or stent placement in acute cholecystitis: a preliminary prospective randomized trial in Japan (with videos). Gastrointest Endosc. 2015;81:111–8.

    Article  PubMed  Google Scholar 

  62. Itoi T, Takada T, Hwang TL, et al. Percutaneous and endoscopic gallbladder drainage for the acute cholecystitis: international multicenter comparative study by a propensity score-matched analysis. J Hepatobiliary Pancreat Sci. 2017;24:362.

    Article  PubMed  Google Scholar 

  63. Teoh AY, Ng EK, Chan SM, et al. Ex vivo comparison of the lumen-apposing properties of EUS-specific stents (with video). Gastrointest Endosc. 2016;84:62–8.

    Article  PubMed  Google Scholar 

  64. Itoi T, Coelho-Prabhu N, Baron TH. Endoscopic gallbladder drainage for management of acute cholecystitis. Gastrointest Endosc. 2010;71:1038–45.

    Article  PubMed  Google Scholar 

  65. Teoh AY, Binmoeller KF, Lau JY. Single-step EUS-guided puncture and delivery of a lumen-apposing stent for gallbladder drainage using a novel cautery-tipped stent delivery system. Gastrointest Endosc. 2014;80:1171.

    Article  PubMed  Google Scholar 

  66. Teoh AY, Chan AW, Chiu PW, et al. In vivo appearances of gallbladder carcinoma under magnifying endoscopy and probe-based confocal laser endomicroscopy after endosonographic gallbladder drainage. Endoscopy. 2014;46(Suppl 1 UCTN):E13–4.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR

    Anthony Yuen Bun Teoh

  2. Department of Gastroenterology, The University of Tokyo, Tokyo, Japan

    Kenjiro Yamamoto & Takao Itoi

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  1. Anthony Yuen Bun Teoh
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  2. Kenjiro Yamamoto
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  3. Takao Itoi
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Correspondence to Anthony Yuen Bun Teoh .

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Editors and Affiliations

  1. Interventional Endoscopy, Division of Gastroenterology, University of Colorado-Denver, Aurora, CO, USA

    Mihir S. Wagh

  2. Interventional Endoscopy, Division of Gastroenterology, University of Colorado-Denver, Aurora, CO, USA

    Sachin B. Wani

Electronic Supplementary Material

EUS-guided antegrade stenting. The left intrahepatic duct was punctured by a 19-gauge needle from the stomach. A guidewire was passed into the liver hilum. A coaxial diathermy was inserted for injection of contrast to delineate the site of obstruction. The guidewire was then manipulated across the stricture and into the duodenum. An uncovered metallic stent was inserted across the stricture in an antegrade manner. (MOV 71072 kb)

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Teoh, A.Y.B., Yamamoto, K., Itoi, T. (2020). Interventional EUS: Bile Duct and Gallbladder. In: Wagh, M., Wani, S. (eds) Gastrointestinal Interventional Endoscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-21695-5_28

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  • DOI: https://doi.org/10.1007/978-3-030-21695-5_28

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