Endoscopy 2019; 51(04): S224-S225
DOI: 10.1055/s-0039-1681841
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Endoscopic ultrasound ePosters
Georg Thieme Verlag KG Stuttgart · New York

BEYOND PALLIATION: USING EUS-GUIDED CHOLEDOCHODUODENOSTOMY WITH A LUMEN-APPOSING METAL STENT AS A BRIDGE TO SURGERY

C Fabbri
1   Unit of Gastroenterology and Digestive Endoscopy, Forlì-Cesena, AUSL Romagna, Forlì-Cesena, Italy
,
A Fugazza
2   Digestive Endoscopy Unit, Department of Gastroenterology, Humanitas Research Hospital, Rozzano (MI), Italy
,
C Binda
3   Internal Medicine, Gastroenterology and Liver Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
,
A Zerbi
4   Pancreatic Surgery Unit, Humanitas Research Hospital, Rozzano (MI), Italy
,
E Jovine
5   Department of Surgery, AUSL Bologna Bellaria-Maggiore Hospital, University of Bologna, Bologna, Italy
,
V Cennamo
6   Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
,
A Repici
7   Digestive Endoscopy Unit, Department of Gastroenterology, Humanitas Research Hospital, Humanitas University, Rozzano (MI), Italy
,
A Anderloni
2   Digestive Endoscopy Unit, Department of Gastroenterology, Humanitas Research Hospital, Rozzano (MI), Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Introduction:

We analyzed the efficacy of pylorus-preserving pancreaticoduodenectomy (PPPD) after endoscopic ultrasonography-guided choledochoduodenostomy (EUS-CD) using a lumen-apposing metal stent (LAMS) as a bridge to surgery.

Patients and methods:

Retrospective multicentric analysis of all consecutive failed-ERCP patients (06/2017 – 10/2017) who subsequently underwent EUS-CD using LAMS, followed by PPPD with resectable distal malignant biliary obstruction.

Results:

Five patients underwent an EUS-CD using EC-LAMS; the bile duct was accessed using the transbulbar approach. The technical success rate of EUS-CD was 100%. No procedure-related adverse events occurred. Five patients underwent PPPD with a technical success rate of 100%.

The presence of a transduodenal LAMS did not impede surgery. No cases of biliary or duodenal fistula occurred. Pancreatic fistulas with late bleeding were observed in 2 patients (1 fatal).

Discussion and conclusion:

These few cases indicate that PPPD after EUS-CD using LAMS is feasible and safe.

EUS-CD should be performed irrespective of the stage of the disease, also for patients fit for surgery.

Additional larger prospective studies are required to confirm this preliminary data, in particular for possible interference with postoperative outcomes.