TY - JOUR
T1 - Endoscopic ultrasound-guided choledochoduodenostomy using single-step lumen-apposing metal stents for primary drainage of malignant distal biliary obstruction (SCORPION-p)
T2 - A prospective pilot study
AU - Fritzsche, Jeska A.
AU - Fockens, Paul
AU - Besselink, Marc. G.
AU - Busch, Olivier
AU - Daams, Freek
AU - Montazeri, Nahid S. M.
AU - Wilmink, Johanna W.
AU - Voermans, Rogier P.
AU - van Wanrooij, Roy L. J.
N1 - Publisher Copyright: © 2023 Georg Thieme Verlag. All rights reserved.
PY - 2023/2/13
Y1 - 2023/2/13
N2 - Background This study aimed to assess the safety and feasibility of endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) using a lumen-apposing metal stent (LAMS) as a primary drainage strategy in patients with distal malignant biliary obstruction (MBO). Methods A prospective, single-center, pilot study was conducted in patients with pathology-confirmed MBO without gastric outlet obstruction. The primary outcome was technical success. Secondary outcomes included clinical success, adverse events (AEs), and reinterventions. The study was registered in the Netherlands Trial Registry (registry number NL9757). Results 22 patients were enrolled (median age 69.5 years [interquartile range 64.75.3]). Technical success was achieved in 20/22 patients (91%). AEs occurred in one patient, namely perforation following inadequate stent deployment (5 %), which was treated in the same procedure. Clinical success was achieved in 19/22 patients (86%). Stent dysfunction was observed in 11/20 patients (55%) after technically successful EUS-CDS: two patients were treated conservatively and nine patients underwent reintervention (s). One patient died within . 30 days due to fulminant disease progression. Conclusions The results confirmed the safety and feasibility of EUS-CDS using LAMS as a primary drainage strategy. The high incidence of stent dysfunction should be improved before EUS-CDS with LAMS can be seen as a valid alternative to endoscopic retrograde cholangiopancreatography.
AB - Background This study aimed to assess the safety and feasibility of endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) using a lumen-apposing metal stent (LAMS) as a primary drainage strategy in patients with distal malignant biliary obstruction (MBO). Methods A prospective, single-center, pilot study was conducted in patients with pathology-confirmed MBO without gastric outlet obstruction. The primary outcome was technical success. Secondary outcomes included clinical success, adverse events (AEs), and reinterventions. The study was registered in the Netherlands Trial Registry (registry number NL9757). Results 22 patients were enrolled (median age 69.5 years [interquartile range 64.75.3]). Technical success was achieved in 20/22 patients (91%). AEs occurred in one patient, namely perforation following inadequate stent deployment (5 %), which was treated in the same procedure. Clinical success was achieved in 19/22 patients (86%). Stent dysfunction was observed in 11/20 patients (55%) after technically successful EUS-CDS: two patients were treated conservatively and nine patients underwent reintervention (s). One patient died within . 30 days due to fulminant disease progression. Conclusions The results confirmed the safety and feasibility of EUS-CDS using LAMS as a primary drainage strategy. The high incidence of stent dysfunction should be improved before EUS-CDS with LAMS can be seen as a valid alternative to endoscopic retrograde cholangiopancreatography.
KW - Biliary drainage
KW - EUS-guided choledochoduodenostomy
KW - Malignant distal biliary obstruction
UR - http://www.scopus.com/inward/record.url?scp=85170656938&partnerID=8YFLogxK
U2 - https://doi.org/10.1055/a-2134-3537
DO - https://doi.org/10.1055/a-2134-3537
M3 - Article
C2 - 37473780
SN - 0013-726X
VL - 56
SP - 47
EP - 52
JO - Endoscopy
JF - Endoscopy
IS - 1
ER -