2026-04-13T06:46:54Zhttps://recercat.cat/oai/request
oai:recercat.cat:2445/2218942025-12-05T12:09:01Zcom_2072_1057col_2072_478916col_2072_478917
RECERCAT author Martínez Moreno, B. author López Roldán, Gonzalo author Escuer-Turu, Julia author Gornals Soler, Joan B. author Loras Alastruey, Carme author Gordo, Ana author Vila, Juan author Bazaga Pérez de Rozas, Sergio author Durá, Miguel author Sanchiz, Vicente author Zaragoza Velasco, Natividad author González Huix, Ferrán author Repiso Ortega, Alejandro author Aparicio Tormo, José Ramón 2025-06-30T08:07:31Z2025-06-30T08:07:31Z2025-05-052025-06-26T09:44:44Z Background and Objectives: Endoscopic retrograde cholangiopancreatography (ERCP) is the primary intervention for malignant distal biliary obstruction (MDBO). However, ERCP may fail for various reasons, requiring alternative interventions such as EUS-guided biliary drainage. Among EUS-guided biliary drainage (EUS-BD) methods, EUS-guided gallbladder drainage (EUS-GBD) is emerging as a viable option for patients who have failed ERCP and EUS-BD. The aim of this study is to evaluate the efficacy and safety of EUS-GBD as salvage therapy for MDBO and its potential role in allowing the initiation of chemotherapy. Methods: This is a retrospective multicenter study of consecutive patients with MDBO with failed ERCP and/or EUS-BD that subsequently underwent EUS-GBD with lumen-apposing metal stent. Results: Ninety-six patients from 9 centers in Spain were included. Technical success was achieved in 99% of patients, while clinical success, defined as bilirubin reduction <50% within 14 days after the procedure, was achieved in 78.1% of patients. Bilirubin levels were normalized in 65.6% of patients. The median time to normalization of bilirubin levels was 15 (7-27) days. Related to continuation of oncological treatment, 44/77 (57.1%) eligible patients were able to start chemotherapy after the procedure, and 12/17 (70.6%) eligible patients underwent surgery in the end. Adverse events were observed in 26.3% of cases, with 3 patients requiring surgery and 3 deaths related to EUS-GBD. Conclusions: EUS-GBD represents a potential alternative to MDBO in cases where ERCP has failed, with an appropriate profile of patients starting chemotherapy. However, in light of the considerable number of adverse events and the moderate efficacy, it may be advisable to consider this approach as a second-line option. cc-by (c) Martínez Moreno et al., 2025 http://creativecommons.org/licenses/by/3.0/es/ info:eu-repo/semantics/openAccess Colangiopancreaticografia retrògrada endoscòpica Malalties dels conductes biliars Endoscopic retrograde cholangiopancreatograph Bile ducts diseases Outcomes of a multicenter registry on EUS-guided gallbladder drainage as a rescue technique for malignant distal biliary obstruction after failed endoscopic retrograde cholangiopancreatography info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion