Prospective randomized trial of EUS versus ERCP-guided common bile duct stone removal: an interim report (with video) - 23/08/11
Reprint requests: Atul Kumar, MD, Stony Brook University, U.S. Department of Veterans Affairs, Stony Brook, NY 11794.Sao Paulo, Brazil, Stony Brook, Brooklyn, New York, Birmingham, Alabama, Houston, Texas, USA
Abstract |
Background |
EUS is being increasingly utilized for the diagnosis of choledocholithiasis and microlithiasis, especially in patients with biliary colic. Simultaneously, there is also a rising interest in the use of EUS for therapeutic interventions.
Objectives |
Our goal was to assess the effectiveness of EUS-directed common bile duct (CBD) stone removal to compare its safety and effectiveness with ERCP-directed intervention.
Design |
Interim results of a prospective, randomized, single-center blinded clinical trial.
Setting |
A single tertiary care referral center.
Patients |
Fifty-two patients with uncomplicated CBD stones were prospectively randomized to CBD cannulation and stone removal under EUS or ERCP guidance.
Main Outcome Measurements and Interventions |
Primary outcome measure was the rate of successful cannulation of the CBD. Secondary outcome measures included successful removal of stones and overall complication rates.
Results |
CBD cannulation followed by stone extraction was successful in 23 of 26 patients (88.5%) in the EUS group (I) versus 25 of 26 patients (96.2%) in the ERCP group (II) (95% CI, −27.65%, 9.88%). Overall, there were 3 complications in the EUS group and 4 complications in the ERCP group.
Limitation |
The current study is an interim report from a single center report and performed by a single operator.
Conclusions |
Our preliminary analysis indicates that outcomes following EUS-guided CBD stone retrieval are equivalent to those following ERCP. EUS-related adverse events are similar to those following ERCP. ERCP and EUS-guided stone retrieval appears to be equally effective for therapeutic interventions of the bile duct. Additional studies are required to validate these preliminary results and to determine predictors of success of EUS-guided stone removal.
Le texte complet de cet article est disponible en PDF.Abbreviations : CBD, ES, NKS
Plan
| DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. |
|
| Presented as an oral presentation at Digestive Disease Week 2007, May 19-23, 2007, Washington, DC (Gastrointest Endosc 2007;65:AB95). |
|
| If you want to chat with an author of this article, you may contact him at atul.kumar2@va.gov. |
Vol 69 - N° 2
P. 238-243 - février 2009 Retour au numéro
Article précédent
- Success rate and complications of ERCP performed during hands-on training courses: a multicenter study in China
- Zhuan Liao, Zhao-Shen Li, Joseph W. Leung, Xiao-Ping Zou, Li-Ping He, Guo-Fa Jia, Qiang Huang, Ming Ji, Liu-Ye Huang, William S.C. Chao
- EUS versus endoscopic retrograde cholangiography for patients with intermediate probability of bile duct stones: a prospective randomized trial
- Tarkan Karakan, Mehmet Cindoruk, Hakan Alagozlu, Meltem Ergun, Sukru Dumlu, Selahattin Unal
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?