Abstract
Objective To study the efficacy of endoscopic ultrasound (EUS)-guided biliary drainage after failed ERCP in patients with malignant obstructive jaundice. Methods 33 patients with malignant obstructive jaundice underwent EUS-guided biliary drainage after unsuccessful ERCP. The operative success rate, recovery of liver function at 1 week and at 1 month after operation, complication rate, hospitalization stay and patients’ survival were analyzed. Results Of 33 patients, a stent was successfully placed using endoscopic ultrasound guidance in 31 patients. These included transgastric puncture in 14 patients, transduo-denal puncture in 17, and by a rendezvous technique in 8. The operative success rate was 93.9%. There were significant differences in the liver function before 1 week or 1 month after the procedure (P<0.05). Two patients who developed bleeding and 1 patient who developed cholangitis responded well to conservative treatment. The complication rate was 9.1%. The hospitalization stay was (21.5±4.7) d and the average survival was 238 d. Conclusion EUS-guided biliary drainage is recommended as a first line treatment after failed ERCP in patients with malignant obstructive jaundice. Key words: Malignant obstructive jaundice; Biliary drainage; Endoscopic ultrasonography; Endoscopic retrograde cholangiopancreatography
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