Safety of Endoscopic Ultrasound-Guided Biliary Drainage in Patients with Distal Malignant Biliary Obstruction with Large-Volume Ascites
Rattachement africain : jp. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Background/Aims: The safety and efficacy of endoscopic ultrasound-guided biliary drainage (EUS-BD) in patients with large-volume ascites (LVA) remain unclear. We aimed to evaluate the safety of EUS-BD in patients with distal malignant biliary obstruction complicated by LVA. Methods: This multicenter retrospective study included patients with distal malignant biliary obstruction who underwent EUS-BD. Pre-procedural computed tomography images were reviewed to identify patients with LVA, which was defined as ascites extending to the perihepatic region. The primary outcome was the safety of EUS-BD. Results: Among 1,524 patients with distal malignant biliary obstruction, 156 (10.2%) had LVA. EUS-BD was performed in 43 patients in whom endoscopic retrograde cholangiopancreatography failed or was infeasible. The technical and clinical success rates for EUS-BD were 97.7% and 81.4%, respectively. Adverse events (AEs), severe AEs, and intra-abdominal AEs (bile leak and peritonitis) occurred in 34.9%, 9.3%, and 18.6% of the patients, respectively. In the multivariate analysis, peritoneal dissemination was identified as an independent risk factor for overall AEs (odds ratio, 4.57; 95% confidence interval, 1.01 to 20.65; p=0.04). In the subgroup analysis, the perihepatic ascites thickness on axial computed tomography images was significantly greater in patients with intra-abdominal AEs than in those without AEs (p<0.01). The receiver operating characteristic curve analysis showed that the perihepatic ascites thickness predicted intra-abdominal AEs (area under the curve, 0.82; optimal cutoff, 15.5 mm). Fourteen patients (32.6%) died during the index hospitalization without discharge, with a median post-procedural survival of 1.8 months. Conclusions: EUS-BD may be associated with a high risk of AEs in patients with LVA, warranting a careful selection of patients.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Safety of Endoscopic Ultrasound-Guided Biliary Drainage in Patients with Distal Malignant Biliary Obstruction with Large-Volume Ascites
- Date Crossref
- 02/09/2026
- Éditeur
- The Editorial Office of Gut and Liver
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
-
Fukuoka University Department of Gastroenterology and Medicine pays non établi dans la noticeUniversité ou école supérieure
-
Kyushu University pays non établi dans la noticeUniversité ou école supérieure
-
Oita University Department of Gastroenterology pays non établi dans la noticeUniversité ou école supérieure
-
Kagoshima City Hospital Department of Gastroenterology pays non établi dans la noticeÉtablissement de santé
-
Kagoshima University Digestive and Lifestyle Diseases pays non établi dans la noticeUniversité ou école supérieure
-
Nagasaki University pays non établi dans la noticeUniversité ou école supérieure
-
Oita Medical Center pays non établi dans la noticeÉtablissement de santé
-
Graduate School of Medical Sciences Department of Medicine and Bioregulatory Science pays non établi dans la noticeUniversité ou école supérieure
-
Graduate School of Biomedical Sciences Department of Gastroenterology and Hepatology pays non établi dans la noticeUniversité ou école supérieure
-
Oita San-ai Medical Center Department of Gastroenterology pays non établi dans la noticeÉtablissement de santé
Department of Gastroenterology and Medicine — Fukuoka University, Kyushu University et Department of Gastroenterology — Oita University, avec 7 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.