• Medicina · Jan 2024

    Review

    Will Endoscopic-Ultrasound-Guided Choledocoduodenostomy with Electrocautery-Enhanced Lumen-Apposing Metal Stent Placement Replace Endoscopic Retrograde Cholangiopancreatography When Treating Distal Malignant Biliary Obstructions?

    • Thomas Guilmoteau, Jérémie Albouys, Abdelkader Taibi, Romain Legros, Marion Schaefer, and Jérémie Jacques.
    • Hepatogastroenterology, Centre Hospitalier Universitaire Dupuytren, 87000 Limoges, France.
    • Medicina (Kaunas). 2024 Jan 27; 60 (2).

    AbstractMalignant distal biliary obstructions are becoming increasingly common, especially in patients with cancers of the pancreatic head, despite progress in medical oncology research. ERCP is the current gold standard for management of such strictures, but the emergence of EC-LAMS has rendered EUS-CDS both safe and efficient. It is a "game changer"; originally intended for ERCP failure, two randomised clinical trials recently proposed EUS-CDS as a first-intent procedure in palliative settings. For resectable diseases, the absence of iatrogenic pancreatitis associated with a lower rate of postsurgical adverse events (compared with ERCP) leads us to believe that EUS-CDS might be used in first-intent as a pre-operative endoscopic biliary drainage.

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