Ali FS, Guha S. Defining failure of endoluminal biliary drainage in the era of endoscopic ultrasound and lumen apposing metal stents. World J Gastroenterol 2024; 30(29): 3534-3537 [DOI: 10.3748/wjg.v30.i29.3534]
Corresponding Author of This Article
Sushovan Guha, MD, PhD, AGAF, FASGE, Professor, Department of Clinical Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, 5055 Medical Cir, Houston, TX 77204, United States. sguha@hrgastro.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Aug 7, 2024; 30(29): 3534-3537 Published online Aug 7, 2024. doi: 10.3748/wjg.v30.i29.3534
Defining failure of endoluminal biliary drainage in the era of endoscopic ultrasound and lumen apposing metal stents
Faisal S Ali, Sushovan Guha
Faisal S Ali, Department of Gastroenterology, Hepatology, and Nutrition, University of Texas Health Science Center at Houston, Huston, TX 77054, United States
Sushovan Guha, Department of Clinical Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX 77204, United States
Author contributions: Ali FS drafted the manuscript; Ali FS and Guha S contributed to the inception; Guha S participated in the final approval of this manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sushovan Guha, MD, PhD, AGAF, FASGE, Professor, Department of Clinical Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, 5055 Medical Cir, Houston, TX 77204, United States. sguha@hrgastro.com
Received: April 8, 2024 Revised: May 12, 2024 Accepted: July 18, 2024 Published online: August 7, 2024 Processing time: 111 Days and 21.9 Hours
Abstract
The role of endoscopy in pathologies of the bile duct and gallbladder has seen notable advancements over the past two decades. With advancements in stent technology, such as the development of lumen-apposing metal stents, and adoption of endoscopic ultrasound and electrosurgical principles in therapeutic endoscopy, what was once considered endoscopic failure has transformed into failure of an approach that could be salvaged by a second- or third-line endoscopic strategy. Incorporation of these advancements in routine patient care will require formal training and multidisciplinary acceptance of established techniques and collaboration for advancement of experimental techniques to generate robust evidence that can be utilized to serve patients to the best of our ability.
Core Tip: For malignant distal biliary obstruction, endoscopic ultrasound (EUS)-guided choledochoduodenostomy is noninferior to endoscopic retrograde cholangiopancreatography (ERCP) with biliary stent placement, and can be considered as a primary drainage modality instead of a salvage method. In cases with malignant hilar biliary obstruction, combined ERCP with EUS-biliary drainage (CERES), when performed in the appropriate patient, can not only provide bilateral drainage but also establish communication of the right and left intrahepatic biliary systems through bridging intra-hepatic stenting. EUS-guided gallbladder drainage (EUS-GBD) is increasingly being recognized as a feasible and efficacious treatment modality and should be considered in the management of cholecystitis in a multidisciplinary setting. EUS-GBD can also be incorporated in the algorithm of management of distal or hilar biliary obstruction, either as a prophylactic or a therapeutic strategy.
