Endoscopy 2025; 57(S 02): S200-S201
DOI: 10.1055/s-0045-1805496
Abstracts | ESGE Days 2025
Moderated poster
EUS guided biliary drainage 03/04/2025, 12:00 – 13:00 Poster Dome 2 (P0)

Endoscopic ultrasound-guided bile duct drainage enhances oncological systemic therapy initiation and capability in patients with non-resectable malignant distal bile duct obstructions compared to percutaneous transhepatic biliary drainage: a comparative

T Heiduk
1   University Medicine Göttingen, Göttingen, Germany
,
A Sasse
1   University Medicine Göttingen, Göttingen, Germany
,
V Ellenrieder
1   University Medicine Göttingen, Göttingen, Germany
,
L Hiebel
1   University Medicine Göttingen, Göttingen, Germany
,
R Knoop
1   University Medicine Göttingen, Göttingen, Germany
,
G Petzold
1   University Medicine Göttingen, Göttingen, Germany
,
A Amanzada
1   University Medicine Göttingen, Göttingen, Germany
› Author Affiliations
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Aims Endoscopic retrograde cholangiopancreaticography (ERCP) is the endoscopic treatment of choice for bile duct drainage in non-resectable malignant distal bile duct obstruction with jaundice in pancreaticobiliary and duodenal neoplasia. Failed ERCP is either followed by endoscopic ultrasound-guided biliary drainage (EUS-BD) or percutaneous transhepatic biliary drainage (PTBD) as an alternative procedure of use. This study compares the ability to initiate and continue oncological systemic therapy in patients treated with EUS-BD versus PTBD. The primary outcomes were the ability to receive oncological systemic therapy and the time interval from intervention to initiation of chemotherapy. Secondary outcomes included total serum bilirubin levels before and after the procedure as well as reintervention and complication rates.

Methods In this retrospective, comparative cohort study, 96 patients (48 in the EUS-BD group and 48 in the PTBD group) were analyzed. Oncological, demographic, and laboratory parameters were examined, focusing on the capability to initiate chemotherapy and the time interval from intervention to chemotherapy initiation. As our data source we used the hospital's own internal database [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19] [20] [21] [22] [23] [24] [25] [26] [27] [28] [29] [30].

Results The EUS-BD group showed a significantly greater reduction in serum bilirubin levels before chemotherapy (2.2 mg/dL vs. 3.9 mg/dL, p=0.01). More patients in the EUS-BD cohort received chemotherapy (69% vs. 48%, p=0.04), and the interval between intervention and chemotherapy initiation was shorter (17 vs. 27 days, p=0.02). The type and number of chemotherapies administered did not differ significantly between the groups (p=0.43; p=0.50; p=0.12). Reinterventions and complication rates were significantly lower in the EUS-BD cohort (6% vs. 60%, p<0.001 and 56% vs. 92%, p<0.001).

Conclusions EUS-BD appears superior to PTBD in facilitating the initiation of oncological systemic therapy in patients with non-resectable malignant distal bile duct obstruction, with fewer complications and a shorter time to treatment initiation. Further multicenter studies are needed to confirm these findings



Publication History

Article published online:
27 March 2025

© 2025. European Society of Gastrointestinal Endoscopy. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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