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Endoscopic ultrasonography-guided rendezvous technique for removal of a long biliary ascariasis: a challenging case.

ABSTRACT: Video 1Video demonstrating the EUS-rendezvous technique for biliary access and removal of a long biliary ascariasis.

SUBMITTER: Sonthalia N

PROVIDER: S-EPMC8645921 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

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Endoscopic ultrasonography-guided rendezvous technique for removal of a long biliary ascariasis: a challenging case.

Sonthalia Nikhil N Rodge Gajanan Ashokrao GA Shah Bhavik Bharat BB Patil Vikram V Goenka Mahesh Kumar MK

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy 20211014 12

Video 1Video demonstrating the EUS-rendezvous technique for biliary access and removal of a long biliary ascariasis. ...[more]

PMID: 34917864

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Project description:BackgroundEndoscopic ultrasound (EUS)-guided biliary rendezvous (RV) is an EUS-assisted technique described as a rescue method in cases of failed biliary cannulation via endoscopic retrograde cholangiography (ERC). Current literature remains unclear regarding its current role. The study aim was to evaluate the effectiveness for biliary EUS-RV, and comparison between benign vs malignant biliopancreatic disorders.MethodsRetrospective observational study with prospective consecutive inclusion in a specific database from a tertiary-center. All patients with biliopancreatic diseases that underwent a EUS-assisted ERC between October-2010 and November-2022 for failed ERC were included. Main outcomes were technical/overall success. Secondary outcomes were safety, potential factors related to failure/success or safety; and a comparative analysis between EUS-RV and EUS-guided transmural drainage (TMD) in malignant cases.ResultsA total of 69 patients who underwent EUS-RV procedures, with benign and malignant pathologies (n = 40 vs n = 29), were included. Technical / overall success and related-adverse events (AEs) were 79.7% (95%CI, 68.3-88.4) / 74% (95%CI, 61-83.7) and 24% (95%CI, 15.1-36.5), respectively. Failed cases were mainly related with guidewire manipulation. Seven failed RV were successfully rescued by EUS-TMD. On multivariable analysis, EUS-RV and malignant pathology was associated with a greater failure rate (technical success: OR,0.21; 95%CI,0.05-0.72; p = 0.017), and higher AEs rate (OR,3.46; 95%CI,1.13-11.5; p = 0.034). Also, the EUS-TMD group had greater technical success (OR,16.96; 95%CI,4.69-81.62; p < 0.001) and overall success (OR, 3.09; 95%CI,1.18-8-16; p < 0.026) with a lower AEs rate (OR,0.30; 95%CI,0.11-0.78; p = 0.014) than EUS-RV in malignant disorders.ConclusionsEUS-RV is a demanding technique with better outcomes in benign than in malignant biliopancreatic diseases. Comparison of the EUS-TMD group on malignant disorders showed worse outcomes with EUS-RV. Given these findings, maybe EUS-RV is not the best option for malignant biliopancreatic disorders.

Dataset Information

Endoscopic ultrasonography-guided rendezvous technique for removal of a long biliary ascariasis: a challenging case.

Publications

Endoscopic ultrasonography-guided rendezvous technique for removal of a long biliary ascariasis: a challenging case.

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