A multi-institution consensus on how to perform EUS-guided biliary drainage for malignant biliary obstruction

Jintao Guo; Marc Giovannini; Anand V. Sahai; Adrian Saftoiu; Christoph F. Dietrich; Erwin Santo; Pietro Fusaroli; Ali A. Siddiqui; Manoop S. Bhutani; Anthony Yuen Bun Teoh; Atsushi Irisawa; Brenda Lucia Arturo Arias; Chalapathi Rao Achanta; Christian Jenssen; Dong Wan Seo; Douglas G. Adler; Evangelos Kalaitzakis; Everson Artifon; Fumihide Itokawa; Jan Werner Poley; Girish Mishra; Khek Yu Ho; Hsiu Po Wang; Hussein Hassan Okasha; Jesse Lachter; Juan J. Vila; Julio Iglesias-Garcia; Kenji Yamao; Kenjiro Yasuda; Kensuke Kubota; Laurent Palazzo; Luis Carlos Sabbagh; Malay Sharma; Mitsuhiro Kida; Mohamed El-Nady; Nam Q. Nguyen; Peter Vilmann; Pramod Kumar Garg; Praveer Rai; Shuntaro Mukai; Silvia Carrara; Sreeram Parupudi; Subbaramiah Sridhar; Sundeep Lakhtakia; Surinder S. Rana; Takeshi Ogura; Todd H. Baron; Vinay Dhir; Siyu Sun

doi:10.4103/eus.eus_53_18

A multi-institution consensus on how to perform EUS-guided biliary drainage for malignant biliary obstruction

Jintao Guo, Marc Giovannini, Anand V. Sahai, Adrian Saftoiu, Christoph F. Dietrich, Erwin Santo, Pietro Fusaroli, Ali A. Siddiqui, Manoop S. Bhutani, Anthony Yuen Bun Teoh, Atsushi Irisawa, Brenda Lucia Arturo Arias, Chalapathi Rao Achanta, Christian Jenssen, Dong Wan Seo, Douglas G. Adler, Evangelos Kalaitzakis, Everson Artifon, Fumihide Itokawa, Jan Werner PoleyGirish Mishra, Khek Yu Ho, Hsiu Po Wang, Hussein Hassan Okasha, Jesse Lachter, Juan J. Vila, Julio Iglesias-Garcia, Kenji Yamao, Kenjiro Yasuda, Kensuke Kubota, Laurent Palazzo, Luis Carlos Sabbagh, Malay Sharma, Mitsuhiro Kida, Mohamed El-Nady, Nam Q. Nguyen, Peter Vilmann, Pramod Kumar Garg, Praveer Rai, Shuntaro Mukai, Silvia Carrara, Sreeram Parupudi, Subbaramiah Sridhar, Sundeep Lakhtakia, Surinder S. Rana, Takeshi Ogura, Todd H. Baron, Vinay Dhir, Siyu Sun^*

^*Corresponding author for this work

Department of Clinical Medicine

20 Citations (Scopus)

Abstract

Background and Objectives: EUS-guided biliary drainage (EUS-BD) was shown to be useful for malignant biliary obstruction (MBO). However, there is lack of consensus on how EUS-BD should be performed. Methods: This was a worldwide multi-institutional survey among members of the International Society of EUS conducted in February 2018. The survey consisted of 10 questions related to the practice of EUS-BD. Results: Forty-six endoscopists of them completed the survey. The majority of endoscopists felt that EUS-BD could replace percutaneous transhepatic biliary drainage after failure of ERCP. Among all EUS-BD methods, the rendezvous stenting technique should be the first choice. Self-expandable metal stents (SEMSs) were recommended by most endoscopists. For EUS-guided hepaticogastrostomy (HGS), superiority of partially-covered SEMS over fully-covered SEMS was not in agreement. 6-Fr cystotomes were recommended for fistula creation. During the HGS approach, longer SEMS (8 or 10 cm) was recommended. During the choledochoduodenostomy approach, 6-cm SEMS was recommended. During the intrahepatic (IH) approach, the IH segment 3 was recommended. Conclusion: This is the first worldwide survey on the practice of EUS-BD for MBO. There were wide variations in practice, and randomized studies are urgently needed to establish the best approach for the management of this condition.

Original language	English
Journal	Endoscopic Ultrasound
Volume	7
Issue number	6
Pages (from-to)	356-365
Number of pages	10
ISSN	2303-9027
DOIs	https://doi.org/10.4103/eus.eus_53_18
Publication status	Published - 2018

Keywords

Consensus
EUS-guided biliary drainage
Questionnaire survey

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10.4103/eus.eus_53_18

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289007/Licence: Other

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Guo, J., Giovannini, M., Sahai, A. V., Saftoiu, A., Dietrich, C. F., Santo, E., Fusaroli, P., Siddiqui, A. A., Bhutani, M. S., Teoh, A. Y. B., Irisawa, A., Arias, B. L. A., Achanta, C. R., Jenssen, C., Seo, D. W., Adler, D. G., Kalaitzakis, E., Artifon, E., Itokawa, F., ... Sun, S. (2018). A multi-institution consensus on how to perform EUS-guided biliary drainage for malignant biliary obstruction. Endoscopic Ultrasound, 7(6), 356-365. https://doi.org/10.4103/eus.eus_53_18

Guo, J, Giovannini, M, Sahai, AV, Saftoiu, A, Dietrich, CF, Santo, E, Fusaroli, P, Siddiqui, AA, Bhutani, MS, Teoh, AYB, Irisawa, A, Arias, BLA, Achanta, CR, Jenssen, C, Seo, DW, Adler, DG, Kalaitzakis, E, Artifon, E, Itokawa, F, Poley, JW, Mishra, G, Ho, KY, Wang, HP, Okasha, HH, Lachter, J, Vila, JJ, Iglesias-Garcia, J, Yamao, K, Yasuda, K, Kubota, K, Palazzo, L, Sabbagh, LC, Sharma, M, Kida, M, El-Nady, M, Nguyen, NQ, Vilmann, P, Garg, PK, Rai, P, Mukai, S, Carrara, S, Parupudi, S, Sridhar, S, Lakhtakia, S, Rana, SS, Ogura, T, Baron, TH, Dhir, V & Sun, S 2018, 'A multi-institution consensus on how to perform EUS-guided biliary drainage for malignant biliary obstruction', Endoscopic Ultrasound, vol. 7, no. 6, pp. 356-365. https://doi.org/10.4103/eus.eus_53_18

@article{fec1fdf030ec488083efe838bb366ca9,

title = "A multi-institution consensus on how to perform EUS-guided biliary drainage for malignant biliary obstruction",

abstract = "Background and Objectives: EUS-guided biliary drainage (EUS-BD) was shown to be useful for malignant biliary obstruction (MBO). However, there is lack of consensus on how EUS-BD should be performed. Methods: This was a worldwide multi-institutional survey among members of the International Society of EUS conducted in February 2018. The survey consisted of 10 questions related to the practice of EUS-BD. Results: Forty-six endoscopists of them completed the survey. The majority of endoscopists felt that EUS-BD could replace percutaneous transhepatic biliary drainage after failure of ERCP. Among all EUS-BD methods, the rendezvous stenting technique should be the first choice. Self-expandable metal stents (SEMSs) were recommended by most endoscopists. For EUS-guided hepaticogastrostomy (HGS), superiority of partially-covered SEMS over fully-covered SEMS was not in agreement. 6-Fr cystotomes were recommended for fistula creation. During the HGS approach, longer SEMS (8 or 10 cm) was recommended. During the choledochoduodenostomy approach, 6-cm SEMS was recommended. During the intrahepatic (IH) approach, the IH segment 3 was recommended. Conclusion: This is the first worldwide survey on the practice of EUS-BD for MBO. There were wide variations in practice, and randomized studies are urgently needed to establish the best approach for the management of this condition.",

keywords = "Consensus, EUS-guided biliary drainage, Questionnaire survey",

author = "Jintao Guo and Marc Giovannini and Sahai, {Anand V.} and Adrian Saftoiu and Dietrich, {Christoph F.} and Erwin Santo and Pietro Fusaroli and Siddiqui, {Ali A.} and Bhutani, {Manoop S.} and Teoh, {Anthony Yuen Bun} and Atsushi Irisawa and Arias, {Brenda Lucia Arturo} and Achanta, {Chalapathi Rao} and Christian Jenssen and Seo, {Dong Wan} and Adler, {Douglas G.} and Evangelos Kalaitzakis and Everson Artifon and Fumihide Itokawa and Poley, {Jan Werner} and Girish Mishra and Ho, {Khek Yu} and Wang, {Hsiu Po} and Okasha, {Hussein Hassan} and Jesse Lachter and Vila, {Juan J.} and Julio Iglesias-Garcia and Kenji Yamao and Kenjiro Yasuda and Kensuke Kubota and Laurent Palazzo and Sabbagh, {Luis Carlos} and Malay Sharma and Mitsuhiro Kida and Mohamed El-Nady and Nguyen, {Nam Q.} and Peter Vilmann and Garg, {Pramod Kumar} and Praveer Rai and Shuntaro Mukai and Silvia Carrara and Sreeram Parupudi and Subbaramiah Sridhar and Sundeep Lakhtakia and Rana, {Surinder S.} and Takeshi Ogura and Baron, {Todd H.} and Vinay Dhir and Siyu Sun",

year = "2018",

doi = "10.4103/eus.eus_53_18",

language = "English",

volume = "7",

pages = "356--365",

journal = "Endoscopic Ultrasound",

issn = "2226-7190",

publisher = "Spring International S & T Publishing Media Co.",

number = "6",

}

TY - JOUR

T1 - A multi-institution consensus on how to perform EUS-guided biliary drainage for malignant biliary obstruction

AU - Guo, Jintao

AU - Giovannini, Marc

AU - Sahai, Anand V.

AU - Saftoiu, Adrian

AU - Dietrich, Christoph F.

AU - Santo, Erwin

AU - Fusaroli, Pietro

AU - Siddiqui, Ali A.

AU - Bhutani, Manoop S.

AU - Teoh, Anthony Yuen Bun

AU - Irisawa, Atsushi

AU - Arias, Brenda Lucia Arturo

AU - Achanta, Chalapathi Rao

AU - Jenssen, Christian

AU - Seo, Dong Wan

AU - Adler, Douglas G.

AU - Kalaitzakis, Evangelos

AU - Artifon, Everson

AU - Itokawa, Fumihide

AU - Poley, Jan Werner

AU - Mishra, Girish

AU - Ho, Khek Yu

AU - Wang, Hsiu Po

AU - Okasha, Hussein Hassan

AU - Lachter, Jesse

AU - Vila, Juan J.

AU - Iglesias-Garcia, Julio

AU - Yamao, Kenji

AU - Yasuda, Kenjiro

AU - Kubota, Kensuke

AU - Palazzo, Laurent

AU - Sabbagh, Luis Carlos

AU - Sharma, Malay

AU - Kida, Mitsuhiro

AU - El-Nady, Mohamed

AU - Nguyen, Nam Q.

AU - Vilmann, Peter

AU - Garg, Pramod Kumar

AU - Rai, Praveer

AU - Mukai, Shuntaro

AU - Carrara, Silvia

AU - Parupudi, Sreeram

AU - Sridhar, Subbaramiah

AU - Lakhtakia, Sundeep

AU - Rana, Surinder S.

AU - Ogura, Takeshi

AU - Baron, Todd H.

AU - Dhir, Vinay

AU - Sun, Siyu

PY - 2018

Y1 - 2018

N2 - Background and Objectives: EUS-guided biliary drainage (EUS-BD) was shown to be useful for malignant biliary obstruction (MBO). However, there is lack of consensus on how EUS-BD should be performed. Methods: This was a worldwide multi-institutional survey among members of the International Society of EUS conducted in February 2018. The survey consisted of 10 questions related to the practice of EUS-BD. Results: Forty-six endoscopists of them completed the survey. The majority of endoscopists felt that EUS-BD could replace percutaneous transhepatic biliary drainage after failure of ERCP. Among all EUS-BD methods, the rendezvous stenting technique should be the first choice. Self-expandable metal stents (SEMSs) were recommended by most endoscopists. For EUS-guided hepaticogastrostomy (HGS), superiority of partially-covered SEMS over fully-covered SEMS was not in agreement. 6-Fr cystotomes were recommended for fistula creation. During the HGS approach, longer SEMS (8 or 10 cm) was recommended. During the choledochoduodenostomy approach, 6-cm SEMS was recommended. During the intrahepatic (IH) approach, the IH segment 3 was recommended. Conclusion: This is the first worldwide survey on the practice of EUS-BD for MBO. There were wide variations in practice, and randomized studies are urgently needed to establish the best approach for the management of this condition.

AB - Background and Objectives: EUS-guided biliary drainage (EUS-BD) was shown to be useful for malignant biliary obstruction (MBO). However, there is lack of consensus on how EUS-BD should be performed. Methods: This was a worldwide multi-institutional survey among members of the International Society of EUS conducted in February 2018. The survey consisted of 10 questions related to the practice of EUS-BD. Results: Forty-six endoscopists of them completed the survey. The majority of endoscopists felt that EUS-BD could replace percutaneous transhepatic biliary drainage after failure of ERCP. Among all EUS-BD methods, the rendezvous stenting technique should be the first choice. Self-expandable metal stents (SEMSs) were recommended by most endoscopists. For EUS-guided hepaticogastrostomy (HGS), superiority of partially-covered SEMS over fully-covered SEMS was not in agreement. 6-Fr cystotomes were recommended for fistula creation. During the HGS approach, longer SEMS (8 or 10 cm) was recommended. During the choledochoduodenostomy approach, 6-cm SEMS was recommended. During the intrahepatic (IH) approach, the IH segment 3 was recommended. Conclusion: This is the first worldwide survey on the practice of EUS-BD for MBO. There were wide variations in practice, and randomized studies are urgently needed to establish the best approach for the management of this condition.

KW - Consensus

KW - EUS-guided biliary drainage

KW - Questionnaire survey

U2 - 10.4103/eus.eus_53_18

DO - 10.4103/eus.eus_53_18

M3 - Journal article

C2 - 30531022

AN - SCOPUS:85058474020

SN - 2226-7190

VL - 7

SP - 356

EP - 365

JO - Endoscopic Ultrasound

JF - Endoscopic Ultrasound

IS - 6

ER -

A multi-institution consensus on how to perform EUS-guided biliary drainage for malignant biliary obstruction

Abstract

Keywords

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