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Biliary Drainage in Patients With Failed ERCP

Percutaneous Versus EUS-guided Drainage

Téllez-Ávila, Félix I. MD, MSc, PhD*; Herrera-Mora, David MD*; Duarte-Medrano, Gilberto MD*; Lopez-Arce, Gustavo MD*; Lindoro-Barraza, Dayana MD*; Casanova, Iván MD; Elizondo-Rivera, Javier MD*; Ramírez-Luna, Miguel MD*; Valdovinos-Andraca, Francisco MD*

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: June 2018 - Volume 28 - Issue 3 - p 183–187
doi: 10.1097/SLE.0000000000000528
Original Articles
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Aim: The goal of the study is to compare the efficacy and safety of bile duct drains guided by endoscopic ultrasound-guided biliary drainage (EGBD) versus percutaneous transhepatic biliary drainage (PTBD).

Materials and Methods: Retrospective comparative study. Patients with obstruction of the bile duct who underwent the EGBD or PTBD procedure and had at least 1 previous endoscopic retrograde cholangiopancreatography that failed or was inaccessible to the second duodenal portion were included.

Results: A total of 90 patients were initially evaluated and 28 were excluded. There were 39 (62.9%) women, with a median age of 55.6 years (range, 22 to 88 y). The etiology of biliary obstruction was malignancy in 35 (56.4%) patients. Differences between EGBD versus PTBD groups were in technical success (90% vs. 78%; P=0.3), clinical success (96% vs. 63%; P=0.04), complications (6.6% vs. 28%; P=0.04), length of stay [6.5 d (range, 0 to 11 d) vs. 12.5 d (range, 6.2 to 25 d)] (P=0.009), and costs 1440.15±240.94 versus 2165.87±241.10 USD (P=0.03).

Conclusions: EGBD is associated with a higher clinical success rate and safety, shorter hospital stays, and lower cost compared with PTBD.

Departments of *Gastrointestinal Endoscopy

Imageology, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico

The authors declare no conflicts of interest.

Reprints: Félix I. Téllez-Ávila, MD, MSc, PhD, Department of Gastrointestinal Endoscopy, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Vasco de Quiroga #15, Tlalpan, CP 14000 Mexico City, Mexico (e-mail: felixtelleza@gmail.com).

Received November 23, 2017

Accepted February 21, 2018

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