Endoscopic ultrasound-guided biliary drainage with placement of a fully covered metal stent for malignant biliary obstruction

Table 1 Patients’ clinical characteristics and results of endoscopic ultrasound-guided biliary drainage (n = 13)

No. of patient	Age/sex	Diagnosis	Reason for failed ERCP	Biliary drainage route	Device for puncture/dilatation	Diameter length of stent (mm/cm)	Technical success	Functional success	Complication	Reintervention	Duration (mo) of 1st stent placement	Status
1	60/M	CBD cancer	Duodenal stenosis due to duodenal ulcer	Transduodenal	19G FN/cystostome	10/6	Success	Success	No	No	Whipple’s operation	Alive
2	83/F	CBD cancer	Failed to access the bile duct	Transduodenal	19G FN/cystostome	10/6	Success	Success	Obstruction	Stent reinsertion	6	Dead
3	76/F	CBD cancer	Failed to access the bile duct	Transduodenal	19G FN/cystostome	10/4	Success	Success	Migration	Stent reinsertion	2	Dead
4	68/F	CBD cancer	Duodenal obstruction due to mass	Transduodenal	19G FN/cystostome	10/6	Success	Success	No	No	7	Alive
5	66/M	Pancreatic cancer	Periampullary tumor infiltration	Transduodenal	19G FN/tapered ERCP cannula and cystostome	10/4	Success	Success	Pneumoperitoneum/peritonitis	No	3	Dead
6	68/M	Pancreatic cancer	Periampullary tumor infiltration	Transduodenal	19G FN/bougie dilatator	10/6	Success	Success	No	No	1	Dead
7	67/F	Pancreatic cancer	Periampullary tumor infiltration	Transduodenal	19G FN/NK and bougie dilatator	10/6	Success	Success	No	No	3	Alive
8	59/M	Pancreatic cancer	Periampullary tumor infiltration	Transduodenal	19G FN/tapered ERCP cannula and cystostome	10/6	Success	Success	No	No	4	Alive
9	80/M	Pancreatic cancer	Periampullary tumor infiltration	Transduodenal	19G FN/tapered ERCP cannula and cystostome	10/6	Success	Success	No	No	3	Alive
10	81/M	Klatskin’s tumor	Stricture could not be crossed (hilar)	Transgastric	19G FN/cystostome	10/6	Success	Fail	Migration/pneumoperitoneum/peritonitis	PTBD	5	Dead
11	55/M	Intrahepatic cholangiocarcinoma	Stricture could not be crossed (hilar)	Transgastric	19G FN/cystostome	10/6	Success	Success	No	No	3	Dead
12	62/M	Pancreatic cancer	Stricture could not be crossed (distal CBD)	Transgastric	19G FN	10/6	Failed					Dead
13	70/M	CBD cancer	Stricture could not be crossed (distal CBD)	Transgastric	19G FN/bougie dilatator	10/6	Success	Success	Migration	Stent reinsertion	2	Alive

F: Female; M: Male; CBD: Common bile duct; G: Gauge; NK: Needel knife; FN: Fine needle; PTBD: Percutaneous biliary drainage; ERCP: Endoscopic retrograde cholangiopancreatography.

Table 2 Summary of published studies and current study on endoscopic ultrasound-guided biliary drainage with metal stent

Study	No. of EUS-BD-metal biliary stents	Technical success %	Clinical success %	Type of metal stent	Procedure-related complications (No. cases)
Will et al[6]	6	100	83.3	Partially covered (3), uncovered (3)	Cholangitis (1)
Artifon et al[27]	1	100	100	Partially covered	None
Bories et al[3]	11	91	100	Partially covered metal stent (3)	Biloma (1), cholangitis (1)
Park et al[9]	9	100	100	Fully covered	Pneumoperitoneum (2)
Park et al[28]	5	100	100	Fully covered	None
Siddiqui et al[29]	8	100	100	Fully covered	Duodenal perforation (1)
This study	13	92.3	91.7	Fully covered	Mild peritonitis (2)

EUS-BD: Endoscopic ultrasound-guided biliary drainage.