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Ultrasound-Guided Endoscopic Biliary Drainage: A Useful Drainage Method for Biliary Decompression in Patients with Biliary Obstructions

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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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Authors and Affiliations

  1. Department of Gastroenterology, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China

    Xiang Wu Jiang, Shao Hui Tang, Jian Quan Yang & Wei Huang

Authors
  1. Xiang Wu Jiang
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  2. Shao Hui Tang
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  3. Jian Quan Yang
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  4. Wei Huang
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Corresponding author

Correspondence to Shao Hui Tang.

Additional information

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

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