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EUS-guided drainage of hepatic abscess and infected biloma using short and long metal stents (with videos)

2015; Elsevier BV; Volume: 81; Issue: 6 Linguagem: Inglês

10.1016/j.gie.2015.01.023

1097-6779

Ryosuke Tonozuka, Takao Itoi, Takayoshi Tsuchiya, Atsushi Sofuni, Kentaro Ishii, Nobuhito Ikeuchi, Junko Umeda, Reina Tanaka, Shuntaro Mukai, Takuji Gotoda, Fuminori Moriyasu,

Amoebic Infections and Treatments

Background Currently, few reports exist on EUS-guided hepatic abscess drainage (EUS-HAD) and EUS-guided biloma drainage (EUS-BLD) using a metal stent. Objective We evaluated the technical success rate and efficacy of EUS-HAD and EUS-BLD for patients with hepatic abscess (HA) and infected biloma. Design Retrospective case series. Setting Single tertiary referral medical center. Patients We evaluated 7 HA and 6 infected biloma patients who were treated between August 2013 and August 2014 at Tokyo Medical University Hospital. Interventions EUS-HAD or EUS-BLD using a short (length, 2 or 3 cm) or long (length, 6 or 8 cm) self-expandable fully covered metal stent. Main Outcome Measurements Technical success, clinical success, and adverse event. Results The overall technical success rate was 100% in both EUS-HAD and EUS-BLD. The clinical success rates of EUS-HAD and EUS-BLD at the first session were 71.4% and 83.3%, respectively. Direct endoscopic necrosectomy was required in 1 case each of HA and infected biloma. The final clinical success rate was 100%. There were no procedure-related adverse events or cases of recurrence during the follow-up period (median, 83.5 days; range, 24-396 days). Limitations Small sample size and no control group. Conclusions EUS-HAD and EUS-BLD using a metal stent can be performed safely and effectively for HA and infected biloma. Currently, few reports exist on EUS-guided hepatic abscess drainage (EUS-HAD) and EUS-guided biloma drainage (EUS-BLD) using a metal stent. We evaluated the technical success rate and efficacy of EUS-HAD and EUS-BLD for patients with hepatic abscess (HA) and infected biloma. Retrospective case series. Single tertiary referral medical center. We evaluated 7 HA and 6 infected biloma patients who were treated between August 2013 and August 2014 at Tokyo Medical University Hospital. EUS-HAD or EUS-BLD using a short (length, 2 or 3 cm) or long (length, 6 or 8 cm) self-expandable fully covered metal stent. Technical success, clinical success, and adverse event. The overall technical success rate was 100% in both EUS-HAD and EUS-BLD. The clinical success rates of EUS-HAD and EUS-BLD at the first session were 71.4% and 83.3%, respectively. Direct endoscopic necrosectomy was required in 1 case each of HA and infected biloma. The final clinical success rate was 100%. There were no procedure-related adverse events or cases of recurrence during the follow-up period (median, 83.5 days; range, 24-396 days). Small sample size and no control group. EUS-HAD and EUS-BLD using a metal stent can be performed safely and effectively for HA and infected biloma.