Surgery or EUS-guided choledochoduodenostomy for malignant distal biliary obstruction after ERCP failure

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Arquivos
art_ARTIFON_Surgery_or_EUSguided_choledochoduodenostomy_for_malignant_distal_biliary_2015.PDF (1.2 MB)
Citações na Scopus
40
Tipo de produção
article
Data de publicação
2015
Editora
MEDKNOW PUBLICATIONS & MEDIA PVT LTD
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
BARON, Todd H.
KAHALEH, Michel
Autor de Grupo de pesquisa
Editores
Coordenadores
Organizadores
Citação
ENDOSCOPIC ULTRASOUND, v.4, n.3, p.235-243, 2015
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background and Objectives: Endoscopic retrograde cholangiopancreatography (ERCP) is the method of choice for drainage in patients with distal malignant biliary obstruction, but it fails in up to 10% of cases. Percutaneous transhepatic cholangiography (PTC) and surgical bypass are the traditional drainage alternatives. This study aimed to compare technical and clinical success, quality of life, and survival of surgical biliary bypass or hepaticojejunostomy (HJT) and endoscopic ultrasound (EUS)-guided choledochoduodenostomy (CDT) in patients with distal malignant bile duct obstruction and failed ERCP. Patients and Methods: A prospective, randomized trial was conducted. From March 2011 to September 2013, 32 patients with malignant distal biliary obstruction and failed ERCP were studied. The HJT group consisted of 15 patients and the CDT group consisted of 14 patients. Technical and clinical success, quality of life, and survival were assessed prospectively. Results: Technical success was 94% (15/16) in the HJT group and 88% (14/16) in the CDT group (P = 0.598). Clinical success occurred in 14 (93%) patients in the HJT group and in 10 (71%) patients in the CDT group (P = 0.169). During follow-up, a statistically significant difference was seen in mean functional capacity scores, physical health, pain, social functioning, and emotional and mental health aspects in both techniques (P < 0.05). The median survival time in both groups was the same (82 days). Conclusion: Data relating to technical and clinical success, quality of life, and survival were similar in patients who underwent HJT and CDT drainage after failed ERCP for malignant distal biliary obstruction.
Palavras-chave
Biliary duct neoplasms, drainage, endoscopic ultrasound, obstructive jaundice, palliative treatment, pancreatic neoplasms
URI
https://observatorio.fm.usp.br/handle/OPI/16427
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/26