Strategic International Session2(JGES・JSGE・JSGS)
Fri. November 3rd   9:00 - 12:00   Room 11: Portopia Hotel South Wing Topaz
Safety of skipping tract dilation step for EUS-guided biliary drainage
Masahiro Itonaga1, Reiko Ashida1, Masayuki Kitano1
1Second Department of Internal Medicine, Wakayama Medical University
Background and aims: The present study retrospectively compared the safety and efficacy of endoscopic ultrasound-guided biliary drainage (EUS-BD) using metal stents with a thin (<7.5 Fr) and a conventional (more than 7.5 Fr) delivery system.
Methods: The present study enrolled 112 patients who underwent EUS-BD using metal stents for unresectable malignant biliary obstruction between April 2016 and July 2022. The primary endpoint was the rate of adverse events (AEs). The secondary endpoints were clinical success rate, procedure time, procedure success rate skipping tract dilation step, recurrent biliary obstruction rate, time to biliary obstruction, and overall survival. Risk factors associated with early AEs were also evaluated.
Results: The rate of early AEs was significantly lower (12% vs. 35%, P=0.013) and the procedure success rate skipping tract dilation step was significantly higher (82% vs. 33%, P<0.001) in the thin than in the conventional delivery system stents. None of the other secondary endpoints differed significantly in the two groups. Multivariate analysis showed that employing tract dilation step during EUS-BD was a significant independent risk factor for early AEs (skipping vs. employing; HR, 9.66; 95% CI, 1.13-83.0, P=0.028).
Conclusions: Employing tract dilation step during EUS-BD was a significant risk factor for early AEs. Metal stents with a delivery diameter <7.5 Fr can be inserted directly skipping tract dilation step, resulting in lower early AE rates.
Index Term 1: EUS-BD
Index Term 2: malignant billiary obstruction
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