Endoscopic ultrasound-guided biliary drainage-current status and future perspectives  

作　　者：Petko Ivanov Karagyozov Ivan Tishkov Irina Boeva Kiril Draganov 

机构地区：[1]Department of Interventional Gastroenterology,Clinic of Gastroenterology,Acibadem City Clinic Tokuda Hopsital,Sofia 1407,Bulgaria [2]Clinic of Liver,Biliary,Pancreatic and General Surgery,Acibadem City Clinic Tokuda Hospital,Sofia 1407,Bulgaria

出　　处：《World Journal of Gastrointestinal Endoscopy》2021年第12期607-618,共12页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：Endoscopic retrograde cholangiopancreatography(ERCP)with stenting is the treatment modality of choice for patients with benign and malignant bile duct obstruction.ERCP could fail in cases of duodenal obstruction,duodenal diverticulum,ampullary neoplastic infiltration or surgically altered anatomy.In these cases percutaneous biliary drainage(PTBD)is traditionally used as a rescue procedure but is related to high morbidity and mortality and lower quality of life.Endoscopic ultrasound-guided biliary drainage(EUS-BD)is a relatively new interventional procedure that arose due to the development of curvilinear echoendoscope and the various endoscopic devices.A large amount of data is already collected that proves its efficacy,safety and ability to replace PTBD in cases of ERCP failure.It is also possible that EUS-BD could be chosen as a first-line treatment option in some clinical scenarios in the near future.Several EUS-BD techniques are developed EUS-guided transmural stenting,antegrade stenting and rendezvous technique and can be personalized depending on the individual anatomy.EUS-BD is normally performed in the same session from the same endoscopist in case of ERCP failure.The lack of training,absence of enough dedicated devices and lack of standardization still makes EUS-BD a difficult and not very popular procedure,which is related to life-threatening adverse events.Developing training models,dedicated devices and guidelines hopefully will make EUS-BD easier,safer and well accepted in the future.This paper focuses on the technical aspects of the different EUS-BD procedures,available literature data,advantages,negative aspects and the future perspectives of these modalities.

关 键 词：Endoscopic ultrasound-guided biliary drainage Malignant bile duct obstruction Endoscopic ultrasound-guided hepaticogastrostomy Endoscopic ultrasoundguided rendezvous technique Endoscopic ultrasound-guided choledochoduodenostomy Endoscopic ultrasound-guided antegrade stenting Endoscopic retrograde cholangiopancreatography 

分 类 号：R657.4[医药卫生—外科学]