Success and safety of endoscopic treatments for concomitant biliary and duodenal malignant stenosis: A review of the literature  

作　　者：Benedetto Mangiavillano Mouen A Khashab Ilaria Tarantino Silvia Carrara Rossella Semeraro Francesco Auriemma Mario Bianchetti Leonardo Henry Eusebi Chen Yen-I Luca De Luca Mario Traina Alessandro Repici 

机构地区：[1]Gastrointestinal Endoscopy Unit [2]Humanitas-Mater Domini [3]Humanitas Huniversity [4]Division of Gastroenterology and Hepatology, Johns Hopkins Hospital [5]Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT) [6]Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center IRCCS [7]Digestive Endoscopy Unit, Istituto Clinico Humanitas Research Hospital [8]Unit of Gastroenterology, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna [9]Gastroenterology and Digestive Endoscopy Unit, Ospedali Riuniti Marche Nord [10]Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital

出　　处：《World Journal of Gastrointestinal Surgery》2019年第2期53-61,共9页世界胃肠外科杂志（英文版）（电子版）

摘　　要：Synchronous biliary and duodenal malignant obstruction is a challenging endoscopic scenario in patients affected with ampullary, peri-ampullary, and pancreatic head neoplasia. Surgical bypass is no longer the gold-standard therapy for these patients, as simultaneous endoscopic biliary and duodenal stenting is currently a feasible and widely used technique, with a high technical success in expert hands. In recent years, endoscopic ultrasonography(EUS) has evolved from a diagnostic to a therapeutic procedure, and is now increasingly used to guide biliary drainage, especially in cases of failed endoscopic retrograde cholangiopancreatography(ERCP). The advent of lumen-apposing metal stents(LAMS) has expanded EUS therapeutic options, and changed the management of synchronous bilioduodenal stenosis. The most recent literature regarding endoscopic treatments for synchronous biliary and duodenal malignant stenosis has been reviewed to determine the best endoscopic approach, also considering the advent of an interventional EUS approach using LAMS.Synchronous biliary and duodenal malignant obstruction is a challenging endoscopic scenario in patients affected with ampullary, peri-ampullary, and pancreatic head neoplasia. Surgical bypass is no longer the gold-standard therapy for these patients, as simultaneous endoscopic biliary and duodenal stenting is currently a feasible and widely used technique, with a high technical success in expert hands. In recent years, endoscopic ultrasonography(EUS) has evolved from a diagnostic to a therapeutic procedure, and is now increasingly used to guide biliary drainage, especially in cases of failed endoscopic retrograde cholangiopancreatography(ERCP). The advent of lumen-apposing metal stents(LAMS) has expanded EUS therapeutic options, and changed the management of synchronous bilioduodenal stenosis. The most recent literature regarding endoscopic treatments for synchronous biliary and duodenal malignant stenosis has been reviewed to determine the best endoscopic approach, also considering the advent of an interventional EUS approach using LAMS.

关 键 词：MALIGNANT BILIARY strictures MALIGNANT DUODENAL STENOSIS Bilio-duodenal STENOSIS BILIARY self-expandable METAL stent DUODENAL self-expandable METAL stent Lumen-apposing METAL stents Gastro-jejunostomy 

分 类 号：R[医药卫生]