Patient perception and preference of EUS-guided drainage over percutaneous drainage when endoscopic transpapillary biliary drainage fails: An international multicenter survey.

Published on Jan 1, 2018in Endoscopic ultrasound4.489
· DOI :10.4103/EUS.EUS_100_17
Kwangwoo Nam4
Estimated H-index: 4
(DU: Dankook University),
Kwangwoo Nam6
Estimated H-index: 6
(DU: Dankook University)
+ 13 AuthorsDo Hyun Park64
Estimated H-index: 64
(UOU: University of Ulsan)
Sources
Abstract
Background and Objectives: EUS-guided biliary drainage (EUS-BD) is a feasible procedure when ERCP fails, as is percutaneous transhepatic BD (PTBD). However, little is known about patient perception and preference of EUS-BD and PTBD. Patients and Methods: An international multicenter survey was conducted in seven tertiary referral centers. In total, 327 patients, scheduled to undergo ERCP for suspected malignant biliary obstruction, were enrolled in the study. Patients received decision aids with visual representation regarding the techniques, benefits, and adverse events (AEs) of EUS-BD and PTBD. Patients were then asked the choice between the two simulated scenarios (EUS-BD or PTBD) after failed ERCP, the reasons for their preference, and whether altering AE rates would influence their prior choice. Results: In total, 313 patients (95.7%) responded to the questionnaire and 251 patients (80.2%) preferred EUS-BD. The preference of EUS-BD was 85.7% (186/217) with EUS-BD expertise, compared to 67.7% (65/96) without EUS-BD expertise (P < 0.001). The main reason for choosing EUS-BD was the possibility of internal drainage (78.1%). In multivariate analysis, the availability of EUS-BD expertise was the single independent factor that influenced patient preference (odds ratio: 3.168; 95% of confidence interval, 1.714-5.856; P < 0.001). The preference of EUS-BD increased as AE rates decreased (P < 0.001). Conclusions: In this simulated scenario, approximately 80% of patients preferred EUS-BD over PTBD after failed ERCP. However, preference of EUS-BD declined as its AE rates increased. Further technical innovations and improved proficiency in EUS-BD for reducing AEs may encourage the use of this procedure as a routine clinical practice when ERCP fails.
📖 Papers frequently viewed together
12 Citations
20197.34Endoscopy
7 Authors (Kirles Bishay, ..., Nauzer Forbes)
15 Citations
1 Citations
References28
Newest
#1Reem Z. Sharaiha (Cornell University)H-Index: 39
#2Muhammad Ali Khan (UTHSC: University of Tennessee Health Science Center)H-Index: 26
Last. Michel Kahaleh (Cornell University)H-Index: 69
view all 8 authors...
Background and Aims EUS-guided biliary drainage (EUS-BD) is increasingly used as an alternate therapeutic modality to percutaneous transhepatic biliary drainage (PTBD) for biliary obstruction in patients who fail ERCP. We conducted a systematic review and meta-analysis to compare the efficacy and safety of these 2 procedures. Methods We searched several databases from inception to September 4, 2016 to identify comparative studies evaluating the efficacy and safety of EUS-BD and PTBD. Primary out...
148 CitationsSource
#1Tae Hoon Lee (SCH: Soonchunhyang University)H-Index: 28
#2Jun-Ho Choi (DU: Dankook University)H-Index: 18
Last. Myung-Hwan Kim (UOU: University of Ulsan)H-Index: 89
view all 11 authors...
Background & Aims Although percutaneous transhepatic biliary drainage (PTBD) is the standard method for draining a malignant biliary obstruction after failed endoscopic retrograde cholangiopancreatographies (ERCPs), use of endoscopic ultrasound–guided transmural biliary drainage (EUS-BD) is increasing. We performed a multicenter, open-label, randomized trial to compare EUS-BD vs PTBD for malignant distal biliary obstruction after a failed ERCP. Methods Patients with unresectable malignant distal...
84 CitationsSource
#1Reem Z. Sharaiha (Cornell University)H-Index: 39
#2Nikhil A. Kumta (Cornell University)H-Index: 23
Last. Michel Kahaleh (Cornell University)H-Index: 69
view all 13 authors...
Background Patients with failed endoscopic retrograde cholangiopancreatography (ERCP) are conventionally offered percutaneous transhepatic biliary drainage (PTBD). While PTBD is effective, it is associated with catheter-related complications, pain, and poor quality of life. Endoscopic ultrasound-guided biliary drainage (EUS-BD) is a minimally invasive endoscopic option increasingly offered as an alternative to PTBD. We compare outcomes of EUS-BD and PTBD in patients with biliary obstruction at a...
50 CitationsSource
#1Muhammad Ali Khan (UTHSC: University of Tennessee Health Science Center)H-Index: 26
#1Muhammad Ali Khan (UTHSC: University of Tennessee Health Science Center)H-Index: 3
Last. Mohammad K. Ismail (UTHSC: University of Tennessee Health Science Center)H-Index: 15
view all 12 authors...
Background and Aims Variable success and adverse event rates have been reported for endoscopic ultrasound-guided biliary drainage (EUS-BD) utilizing either extrahepatic or intrahepatic approach. We aimed to conduct a proportion meta-analysis to evaluate the cumulative efficacy and safety of EUS-BD and to compare the two approaches and transluminal methods of EUS-BD.
102 CitationsSource
#1Gregory A. Cote (IU: Indiana University)H-Index: 42
#2Sheryl Lynch (IU: Indiana University)H-Index: 3
Last. Huiping Xu (IU: Indiana University)H-Index: 22
view all 8 authors...
Background & Aims In outpatients undergoing endoscopic retrograde cholangiopancreatography (ERCP) with anesthesia, rates of and risk factors for admission are unclear. We aimed to develop a model that would allow physicians to predict hospitalization of patients during postanesthesia recovery. Methods We conducted a retrospective study of data from ERCPs performed on outpatients from May 2012 through October 2013 at the Indiana University School of Medicine. Medical records were abstracted for p...
7 CitationsSource
#1Aanand D. Naik (Michael E. DeBakey Veterans Affairs Medical Center in Houston)H-Index: 39
#2Hashem B. El-Serag (Michael E. DeBakey Veterans Affairs Medical Center in Houston)H-Index: 121
5 CitationsSource
#1Do Hyun Park (UOU: University of Ulsan)H-Index: 64
#2Seung Uk Jeong (UOU: University of Ulsan)H-Index: 5
Last. Myung-Hwan Kim (UOU: University of Ulsan)H-Index: 89
view all 7 authors...
Background: EUS-guided biliary drainage (EUS-BD) was introduced as an effective alternative to percutaneous transhepatic biliary drainage after failed ERCP. However, EUS-BD is technically challenging. The intraductal manipulation of the guidewire seems to be the most difficult stage of the procedure. Therefore, technical advances in guidewire manipulation may be required for EUS-BD. Objective: To evaluate our treatment algorithm for guidewire manipulation protocol for EUS-BD after failed ERCP. D...
135 CitationsSource
Section 3506 of the Affordable Care Act encourages use of shared decision making in health care, but progress on this front has been slow. The first step is for the Centers for Medicare and Medicaid Services to begin certifying and implementing patient decision aids.
507 CitationsSource
#1Everson L.A. Artifon (USP: University of São Paulo)H-Index: 32
#2Dayse P. AparicioH-Index: 6
Last. Kapil GuptaH-Index: 11
view all 8 authors...
BACKGROUND: Endoscopic retrograde cholangiopancreatography may fail because of malignant involvement of the second portion of the duodenum and the major papilla. Alternatives include percutaneous transhepatic biliary drainage (PTBD) or surgical bypass. Endoscopic ultrasonography-guided choledochoduodenostomy (EUS-CD) has been reported as an alternative. OBJECTIVE: To prospectively compare EUS-CD and PTBD in patients with unresectable malignant biliary obstruction. DESIGN: Prospective and randomi...
147 CitationsSource
#1Neena S. Abraham (BCM: Baylor College of Medicine)H-Index: 41
#2Aanand D. Naik (BCM: Baylor College of Medicine)H-Index: 39
Last. Richard L. Street (BCM: Baylor College of Medicine)H-Index: 67
view all 3 authors...
13 CitationsSource
Cited By21
Newest
#1Aymen Almuhaidb (NU: Northwestern University)
#2Dylan Olson (NU: Northwestern University)
Last. A. Aziz Aadam (NU: Northwestern University)H-Index: 8
view all 3 authors...
Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic technique in which a specialized side-viewing endoscope is guided into the duodenum, allowing for instruments to access the biliary and pancreatic ducts. ERCP was initially developed as a diagnostic tool as computed tomography was in its infancy during that time. ERCP has evolved since its inception in the 1960s to becoming not only a valuable diagnostic resource but now an effective therapeutic intervention in the treatment ...
Source
#1Bashar J. Qumseya (UF: University of Florida)H-Index: 20
#2Laith H. Jamil (Oakland University)H-Index: 2
Last. Sachin Wani (Anschutz Medical Campus)H-Index: 68
view all 21 authors...
This clinical guideline from the American Society for Gastrointestinal Endoscopy (ASGE) provides an evidence-based approach for the management of patients with malignant hilar obstruction (MHO). This document was developed using the Grading of Recommendations Assessment, Development and Evaluation framework and addresses primary drainage modality (percutaneous transhepatic biliary drainage [PTBD] vs endoscopic biliary drainage [EBD]), drainage strategy (unilateral vs bilateral), and stent select...
Source
#1Pouya Entezari (NU: Northwestern University)H-Index: 1
#2Jonathan A. Aguiar (NU: Northwestern University)
Last. Ahsun Riaz (NU: Northwestern University)H-Index: 8
view all 4 authors...
Acute cholangitis presents with a wide severity spectrum and can rapidly deteriorate from local infection to multiorgan failure and fatal sepsis. The pathophysiology, diagnosis, and general management principles will be discussed in this review article. The focus of this article will be on the role of biliary drainage performed by interventional radiology to manage acute cholangitis. There are specific scenarios where percutaneous drainage should be preferred over endoscopic drainage. Percutaneo...
Source
Background Endoscopic ultrasound (EUS)-guided ductal access and drainage (EUS-DAD) of biliary/pancreatic ducts after failed endoscopic retrograde cholangiopancreatography (ERCP) is less invasive than percutaneous transhepatic biliary drainage (PTBD). The actual need for EUS-DAD remains unknown. We aimed to determine how often EUS-DAD is needed to overcome ERCP failure. Methods Consecutive duct access procedures (n = 2205; 95 % biliary) performed between June 2013 and November 2015 at a tertiary-...
1 CitationsSource
#1Thomas M. Runge (Johns Hopkins University)H-Index: 3
#2Austin L. Chiang (Thomas Jefferson University Hospital)H-Index: 4
Last. Mouen A. Khashab (Johns Hopkins University)H-Index: 69
view all 31 authors...
Background Endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography (ERCP; EDGE) is an alternative to enteroscopy- and laparoscopy-assisted ERCP in patients with Roux-en-Y gastric bypass anatomy. Although short-term results are promising, the long-term outcomes are not known. The aims of this study were: (1) to determine the rates of long-term adverse events after EDGE, with a focus on rates of persistent gastrogastric or jejunogastric fistula; (2) to identify p...
3 CitationsSource
#1Jason G. Bill (UIC: University of Illinois at Chicago)H-Index: 4
#2Marvin Ryou (Brigham and Women's Hospital)H-Index: 26
Last. Vladimir Kushnir (WashU: Washington University in St. Louis)H-Index: 25
view all 17 authors...
BACKGROUND AND AIMS Biliary drainage using endoscopic ultrasound (EUS-BD) has been developed as a novel technique to obtain biliary access and drainage when ERCP fails. Numerous studies have demonstrated its safety and efficacy specifically pertaining to those with malignant distal biliary obstruction or altered foregut anatomy. The aim of this study is to evaluate the safety and efficacy of EUS-BD in benign indications in patients with normal foregut anatomy. METHODS We performed a retrospectiv...
Source
#1Michael MakarH-Index: 3
#2Eric Zhao (RU: Rutgers University)H-Index: 4
Last. Amy TybergH-Index: 21
view all 3 authors...
Pancreaticobiliary malignancies arise from different areas within the pancreas and biliary tree. Endoscopic ultrasound (EUS) is a well-recognized diagnostic and therapeutic modality in the treatment of pancreaticobiliary diseases, and more specifically, pancreaticobiliary malignancies. Traditionally used for diagnostic purposes, EUS plays a critical role in tissue sampling and cancer staging. The emergence of the new field of interventional EUS has allowed EUS to also play a critical role in the...
Source
#1Takafumi Mie (JFCR: Japanese Foundation for Cancer Research)H-Index: 1
#2Takashi Sasaki (JFCR: Japanese Foundation for Cancer Research)H-Index: 7
Last. Naoki Sasahira (JFCR: Japanese Foundation for Cancer Research)H-Index: 6
view all 9 authors...
Intraductal papillary mucinous neoplasm (IPMN) sometimes forms fistulas with other organs due to high pressure of pancreatic duct filled with huge amount of mucus. Pancreatobiliary fistula may cause obstructive jaundice due to the mucus and it is hard to manage the jaundice by endoscopic biliary stenting because of high viscosity of the bile. We report a case of IPMN with pancreatobiliary fistula managed by endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS). The patient was 87 years ol...
Source
Source
#1Simon HerrmannH-Index: 1
#2M GötzbergerH-Index: 7
Last. Markus DollhopfH-Index: 8
view all 3 authors...
Source