[Effectiveness of endoscopic ultrasound-guided biliary drainage in patients experiencing obstructive jaundice due to unsuccessful endoscopic retrograde cholangiopancreatography].

G Zhang, G P Zhao, Z Liang, S T Zhang
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Abstract

Objective: To assess the treatment outcomes of endoscopic ultrasound-guided biliary drainage (EUS-BD) in patients with obstructive jaundice due to unsuccessful endoscopic retrograde cholangiopancreatography (ERCP). Methods: The clinical data of patients with obstructive jaundice who underwent EUS-BD due to ERCP failure at the Gastrointestinal Endoscopy Center of Beijing Friendship Hospital from September 2018 to November 2023, was retrospectively collected and analyzed. We explored the technical success, clinical success, and adverse events associated with EUS-BD. Results: In total, 43 EUS-BD procedures were performed in 39 patients with a technical success rate of 86.0% (37/43). The clinical success rate was 81.1% (30/37). Biliary drainage was not effectively achieved in seven cases, including two fatal cases and five cases of recurrent postoperative biliary obstruction. The incidence of adverse events was 21.6% (8/37), including two cases of postoperative bile leakage peritonitis, two cases of stent displacement, one case of stent dislocation, one case of perforation, and two cases of death. Conclusion: EUS-BD is a relatively safe and effective method for bile duct drainage, serving as a dependable alternative therapeutic option for patients with obstructive jaundice due to unsuccessful ERCP.

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[因内镜逆行胰胆管造影术失败而出现梗阻性黄疸的患者接受内镜超声引导胆道引流术的效果]。
目的评估因内镜逆行胰胆管造影术(ERCP)不成功而导致梗阻性黄疸的患者接受内镜超声引导胆道引流术(EUS-BD)的治疗效果。方法回顾性收集并分析2018年9月至2023年11月北京友谊医院消化内镜中心因ERCP失败而接受EUS-BD治疗的梗阻性黄疸患者的临床资料。我们探讨了与EUS-BD相关的技术成功率、临床成功率和不良事件。结果:共为39名患者实施了43例EUS-BD手术,技术成功率为86.0%(37/43)。临床成功率为 81.1%(30/37)。有 7 例患者未能有效实现胆道引流,其中包括 2 例死亡病例和 5 例术后复发胆道梗阻病例。不良事件发生率为 21.6%(8/37),包括 2 例术后胆汁渗漏性腹膜炎、2 例支架移位、1 例支架脱位、1 例穿孔和 2 例死亡。结论EUS-BD 是一种相对安全、有效的胆管引流方法,可作为ERCP失败导致梗阻性黄疸患者的可靠替代治疗方案。
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