Abstract
Background
Endoscopic retrograde cholangiopancreatography with fluoroscopy guidance is a well-established technique for providing biliary drainage in patients with biliary obstructions. However, fluoroscopic facilities may not always be available and fluoroscopy carries a risk of radiation exposure.
Aim
We retrospectively compared the procedure success rate and efficacy of ultrasound-guided endoscopic biliary drainage (UG-EBD) and fluoroscopy-guided endoscopic biliary drainage (FG-EBD) in patients with biliary obstructions.
Methods
Patients who had received either UG-EBD or FG-EBD were included in the study. Main outcome measurements included the procedure success rate, procedure time, and clinical response.
Results
A total of 125 patients who had undergone UG-EBD (n = 63) and FG-EBD (n = 62) were identified. The total procedure success rate was 93.7 % in the UG-EBD group and 96.8 % in the FG-EBD group without statistical difference. Also, no significant difference was found in the procedure success rate of lower or upper/middle obstructions of the common bile duct (CBD) between the 2 groups. The mean procedure time was not different between the 2 groups [UG-EBD group 24.54 (9.52) min vs. FG-EBD group 21.74 (8.77) min, p = 0.09]. There were no differences in the normalization of clinical and laboratory parameters and immediate complication between the 2 groups.
Conclusions
Endoscopic biliary drainage (EBD) under US-guidance and under fluoroscopy guidance is equally effective and safe for patients with lower or upper/middle obstructions of the CBD. The UG-EBD technique is especially suitable for special patients, such as critically ill patients, pregnant woman, etc.
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Abbreviations
- CBD:
-
Common bile duct
- CT:
-
Computed tomography
- EBD:
-
Endoscopic biliary drainage
- ENBD:
-
Endoscopic nasobiliary drainage
- ERBD:
-
Endoscopic retrograde biliary drainage
- ERCP:
-
Endoscopic retrograde cholangiopancreatography
- FG-EBD:
-
Fluoroscopy-guided endoscopic biliary drainage
- HCC:
-
Hepatocellular carcinoma
- MD:
-
Doctor of Medicine
- MM:
-
Master of Medicine
- MRCP:
-
Magnetic resonance cholangiopancreatography
- UG-EBD:
-
Ultrasound-guided endoscopic biliary drainage
- US:
-
Ultrasound
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Xiang Wu Jiang and Shao Hui Tang have contributed equally to this work.
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Jiang, X.W., Tang, S.H., Yang, J.Q. et al. Ultrasound-Guided Endoscopic Biliary Drainage: A Useful Drainage Method for Biliary Decompression in Patients with Biliary Obstructions. Dig Dis Sci 59, 161–167 (2014). https://doi.org/10.1007/s10620-013-2868-6
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DOI: https://doi.org/10.1007/s10620-013-2868-6