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Gastrointestinal Endoscopy

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Initial experience with EUS-guided cholangiopancreatography for biliary and pancreatic duct drainage: a Spanish national survey - 18/11/12

Doi : 10.1016/j.gie.2012.08.001 
Juan J. Vila, MD 1, ⁎, Manuel Pérez-Miranda, MD 2, Enrique Vazquez-Sequeiros, MD 3, 4, Monder Abu-Suboh Abadia, MD 5, Antonio Pérez-Millán, MD 6, Ferrán González-Huix, MD 7, Joan Gornals, MD 8, Julio Iglesias-Garcia, MD 9, Carlos De la Serna, MD 2, José R. Aparicio, MD 10, José C. Subtil, MD 11, Alberto Álvarez, MD 12, Felipe de la Morena, MD 13, Jesús García-Cano, MD 14, María A. Casi, MD 15, Angel Lancho, MD 16, Angel Barturen, MD 17, Santiago J. Rodríguez-Gómez, MD 18, Alejandro Repiso, MD 19, Diego Juzgado, MD 4, Francisco Igea, MD 6, Ignacio Fernandez-Urien, MD 1, Juan A. González-Martin, MD 3, José R. Armengol-Miró, MD 5
1 Department of Gastroenterology, Endoscopy Unit A, Complejo Hospitalario de Navarra, Pamplona, Spain 
2 Endoscopy Unit, Hospital Rio Hortega, Valladolid, Spain 
3 Endoscopy Unit, Hospital Ramón y Cajal, Madrid, Spain 
4 Endoscopy Unit, Hospital Quirón, Madrid, Spain 
5 Endoscopy Unit, Hospital Vall d′Hebron, Barcelona, Spain 
6 Endoscopy Unit, Hospital Río Carrión, Palencia, Spain 
7 Endoscopy Unit, Hospital Josep Trueta, Girona, Spain 
8 Endoscopy Unit, Hospital Universitario Bellvitge, Barcelona, Spain 
9 Endoscopy Unit, Hospital Clinico, Santiago de Compostela, Spain 
10 Endoscopy Unit, Hospital General Universitario, Alicante, Spain 
11 Endoscopy Unit, Clínica Universidad de Navarra, Pamplona, Spain 
12 Endoscopy Unit, Hospital Universitario, Salamanca, Spain 
13 Endoscopy Unit, Hospital Infanta Cristina, Madrid, Spain 
14 Endoscopy Unit, Hospital Virgen de la Luz, Cuenca, Spain 
15 Endoscopy Unit B, Complejo Hospitalario de Navarra, Pamplona, Spain 
16 Endoscopy Unit, Hospital Xeral, Lugo, Spain 
17 Endoscopy Unit, Hospital de Cruces, Bilbao, Spain 
18 Endoscopy Unit, Hospital Virgen de la Concha, Zamora, Spain 
19 Endoscopy Unit, Hospital Virgen de la Salud; Toledo, Spain 

Reprint requests: Juan J. Vila, MD, Department of Gastroenterology, Endoscopy Unit A, Complejo Hospitalario de Navarra, C/Irunlarrea, 3 31008 Pamplona, Spain

Riassunto

Background

EUS-guided cholangiopancreatography (ESCP) allows transmural access to biliopancreatic ducts when ERCP fails. Data regarding technical details, safety, and outcomes of ESCP are still unknown.

Objective

To evaluate outcomes of ESCP in community and referral centers at the initial development phase of this procedure, to identify the ESCP stages with higher risk of failure, and to evaluate the influence on outcomes of factors related to the endoscopist.

Design

Multicenter retrospective study.

Setting

Public health system hospitals with experience in ESCP in Spain.

Patients

A total of 125 patients underwent ESCP in 19 hospitals, with an experience of <20 procedures.

Intervention

ESCP.

Main Outcome Measurements

Technical success and complication rates in the initial phase of implantation of ESCP are described. The influence of technical characteristics and endoscopist features on outcomes was analyzed.

Results

A total of 125 patients from 19 hospitals were included. Biliary ESCP was performed in 106 patients and pancreatic ESCP was performed in 19. Technical success was achieved in 84 patients (67.2%) followed by clinical success in 79 (63.2%). Complications occurred in 29 patients (23.2%). Unsuccessful manipulation of the guidewire was responsible for 68.2% of technical failures, and 58.6% of complications were related to problems with the transmural fistula.

Limitations

Retrospective study.

Conclusion

Outcomes of ESCP during its implantation stage reached a technical success rate of 67.2%, with a complication rate of 23.2%. Intraductal manipulation of the guidewire seems to be the most difficult stage of the procedure.

Il testo completo di questo articolo è disponibile in PDF.

Abbreviations : ESCP, PBD


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 If you would like to chat with an author of this article, you may contact Dr Vila at juanjvila@gmail.com.
 DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.


© 2012  American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 76 - N° 6

P. 1133-1141 - dicembre 2012 Ritorno al numero
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