Clinical and Technical Success of Eus-guided Anterograde Drainage for Non-neoplastic Obstructed Biliary and Pancreatic Ducts: A single-center experience

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Abstract
Aims To assess the anterograde's drainage clinical and technical success in non-neoplastic obstructed biliary and pancreatic ducts. Methods Data from patients with an obstructed biliary or pancreatic duct between 01/2021-10/2022 were retrospectively analyzed. Clinical and technical success were the primary endpoints. Adverse events, re-stenosis, and re-intervention were also evaluated ([Table 1]). Results Twenty patients included: 15/20 EUS-guided biliary drainage (EUS-BD) and 5/20 EUS-guided pancreatic duct drainage (EUS-PDD). A) EUS-BD: Anterograde drainage was performed in 7/15 using a single pigtail stent, 5/15 double pigtail stents and 3/15 lumen-apposing metal stent (LAMS). Stomach puncture was the preferred approach site in 12/15. A 15/15 (100%) technical success was achieved, but a 8/15 (60%) clinical success based on bilirubin decrease. During follow-up, adverse events were documented in 5/15 cases: upper GI bleeding, cholangitis, and subhepatic fluid collection. Stent migrated in 3/15 cases. There was no re-stenosis, but reintervention was necessary on 8/15. Survival rate 13/15. B) EUS-PDD: In 3/5 cautery-assisted dilation was required. In 1/5, balloon dilation was also necessary. Used stents: single and double pigtail stents, LAMS, and self-expandable metal stents (SEMS). Technical and clinical success was achieved in 5/5 (100%), with no adverse events [1] [2] [3]. Conclusions Anterograde EUS-BD and EUS-PDD for managing non-neoplastic obstructed biliary and pancreatic ducts are valuable alternatives when ERCP is not feasible. Reintervention after EUS-BD and EUS-PDD appears to be related to stent migration and re-stenosis, respectively. Article published online: 14 April 2023 © 2023. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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