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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(07): E998-E1003
DOI: 10.1055/a-1838-2683
Original article

EUS-guided biliary drainage with a novel electrocautery-enhanced lumen apposing metal stent as first approach for distal malignant biliary obstruction: a prospective study

Benedetto Mangiavillano
1   Gastrointestinal Endoscopy Unit – Humanitas Mater Domini – Castellanza (VA), Italy
2   Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy
,
Jong Ho Moon
3   Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Korea
,
Antonio Facciorusso
4   Gastroenterology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
,
Francesco Di Matteo
5   Digestive Endoscopy, Campus-Bio Medico University, Rome, Italy
,
Danilo Paduano
1   Gastrointestinal Endoscopy Unit – Humanitas Mater Domini – Castellanza (VA), Italy
,
Milutin Bulajic
6   Digestive Endoscopy, Mater Olbia Hospital, Olbia, Italy
,
Andrew Ofosu
7   Division of Digestive Diseases, University of Cincinnati, Cincinnati, Ohio, United States
,
Francesco Auriemma
1   Gastrointestinal Endoscopy Unit – Humanitas Mater Domini – Castellanza (VA), Italy
,
Laura Lamonaca
1   Gastrointestinal Endoscopy Unit – Humanitas Mater Domini – Castellanza (VA), Italy
,
Hae Won Yoo
3   Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Korea
,
Roberta Rea
5   Digestive Endoscopy, Campus-Bio Medico University, Rome, Italy
,
Marco Massidda
6   Digestive Endoscopy, Mater Olbia Hospital, Olbia, Italy
,
Alessandro Repici
2   Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy
8   Humanitas Clinical and Research Center – IRCCS, Rozzano (MI), Italy
› Author AffiliationsTRIAL REGISTRATION: Prospective trial at http://www.clinicaltrials.gov/
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Abstract

Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) represents the gold standard for jaundice palliation in malignant biliary obstruction (MBO) patients. Biliary drainage using electrocautery lumen apposing metal stent (EC-LAMS) is currently a well-established procedure when ERCP fails. We aimed to assess the technical and clinical success of a new EC-LAMS as the first approach to the palliation of malignant jaundice due to MBO in patients unfit for surgery.

Patients and methods Twenty-five consecutive patients undergoing endoscopic-guided biliary drainage with the new EC-LAMS were prospectively enrolled. Clinical success was defined as bilirubin level decrease > 15 % 24 hours after EC-LAMS placement.

Results Mean age was 76.6 ± 11.56 years, and male patients were 10 (40 %). EC-LAMS placement was technically feasible in 24 patients (96 %) and clinical success rate was 100 %. Only one patient (4 %) experienced a misplacement rescued by an immediate second EC-LAMS placement. The mean duration of hospital stay was 4.66 ± 4.22 days. The median overall survival was 7 months (95 % CI 1–7).

Conclusions In this preliminary study, the new EC-LAMS seems to allow a single-step palliative endoscopic therapy in patients affected by jaundice due to MBO, with high technical and clinical success and low adverse events. Further large prospective studies are warranted to validate these results.



Publication History

Received: 21 February 2022

Accepted after revision: 21 April 2022

Article published online:
15 July 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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