Pain scores were assessed using visual analogue scale while QoL w

Pain scores were assessed using visual analogue scale while QoL was assessed using the EORTC-QLQ-30 instrument, Global health status/Quality of life score. Adverse events Paclitaxel were graded according to the ASGE lexicon’s severity grading system. Results: A total of 45 patients (age 63 ± 17 yr, female 35%, pancreatic cancer 78% underwent EUS-BD [REN 12, AG 7, TL 26 (Choledochoduodenostomy 18, Hepatogastrostomy 5, Hepatoduodenostomy 3)]. Reason for EUS-BD was obscured ampulla by invasive cancer or enteral stent

(65%), altered anatomy (11%), failed deep biliary cannulation (22%), and gastric outlet obstruction (2%). Electrocautery was used during 32% of procedures. EUS-guided cholangiography was successful in all patients (100%). Mean intra- or extra- hepatic bile duct diameter was 13.1 mm (range 1–25 mm). Stent placement Bioactive Compound Library in desired location (technical success) was achieved in 44 (97.8%) patients (metallic stent 40, plastic stent 5). Mean procedure time was 42.8 ± 33 mins. Clinical success was attained in 41/45 (91%) patients of who achieved technical success. There

was significant decrease in bilirubin at 4 weeks (246.2 ± 164.2 vs. 37.6 ± 27.3 μmol/L, p < 0.001). Mean length of hospital stay was 2.9 days. A total of 5 (11.1%) adverse events occurred (2 moderate: bile leak, sheared wire and 3 mild: 1 pancreatitis, 2 pain managed conservatively). During long-term follow-up of 113.4 ± 109.3 days, 10 patients died because of disease progression with patent stents in place at a mean of 80.4 ± 77.8 days after EUS-BD. One patient had stent occlusion (metal stent) treated with endoscopic cleansing

and placement of plastic stent. Three patients had stent migration (metal stents). QoL score improved 4 weeks after medchemexpress EGBD (39.3 ± 20.0 vs. 50.0 ± 22.2, P = 0.33). Conclusions: Excellent efficacy and safety of EUS-BD in the management of distal malignant biliary obstruction after failed ERCP is demonstrated in a rigorous ongoing prospective international study. P SAXENA,1 V KUMBHARI,1 M EL ZEIN,1 A ABDELGELIL,1 S BESHARATI,1 A MESALLAM,1 T STEVENS,2 EJ SHIN,1 VK SINGH,1 AM LENNON,1 MI CANTO,1 MA KHASHAB1 1Division of Medicine, Department of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, MD, USA, 2Division of Medicine, Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA Background: Emerging data suggests that needle aspiration techniques have direct effect on yield of EUS-FNA. Standard FNA procedures involve use of “no-suction” or “suction” aspiration techniques. However, recent data suggests that using minimal negative pressure provided by pulling the needle stylet slowly and continuously (capillary suction technique) is associated with improved diagnostic yield.

Comments are closed.