Strategic International Session2(JGES・JSGE・JSGS)
Fri. November 3rd   9:00 - 12:00   Room 11: Portopia Hotel South Wing Topaz
Utility of Forward-viewing EUS-Biliary drainage (FVEUS-BD) via afferent loop for treatment of choledochojejunal anastomotic stenosis
Daiki Agarie1, Susumu Hijioka1, Takuji Okusaka1
1Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital
Although the choledochojejunal anastomotic stenosis is usually treated by balloon enteroscope-assisted ERC(BE-ERC), we occasionally experience difficult cases due to severe stenosis. Recently, the usefulness of Forward-viewing EUS-BD via afferent loop (FVEUS-BD via AL) has been reported in such cases.
Here, we evaluated the utility of FVEUS-BD via AL for treatment of choledochojejunal anastomotic stenosis.
We retrospectively reviewed the outcomes of 9 cases who underwent FVEUS-BD via AL because BE-ERC could not be performed due to severe stenosis.
The composition of 9 cases was benign/malignant 5/4. Reconstruction type: Child/Roux-en-Y 8/1. The success rate of reaching anastomotic site was 100% (9/9), and the technical success rate for drainage was 100% (9/9).
Recurrent biliary obstruction (RBO) was observed in 2 patients, Time to RBO was 88 days (range: 19-NA).
In 5 cases of benign, the stent was removed after a certain period of stenting with the intention of achieving stent-free (median: 88 days). In 3 cases, restenosis was observed after removal of the stent. Re-intervention was performed from the created fistula, and the stent was removed after being implanted again for a certain period. In the end, 4 cases were able to be followed up without stent.
This method was considered useful because of its high success rate and possibility exists that it could be stent-free.
Index Term 1: FVEUS
Index Term 2: EUS-BD
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