IDDF2019-ABS-0142 Combination of ERCP and EUS-guided biliary drainage (CERES) versus PTBD for malignant hilar biliary obstruction: a multicenter prospective comparative cohort study (the CERES study). (June 2019)

• Record Type: Journal Article
• Authors: Orprayoon, Theerapat; Kongkam, Pradermchai; Boonmee, Chaloemphon; Sodarat, Passkorn; Seabmuangsai, Orathai; Romano, Rommel; Jangsirikul, Sureeporn; Ridtitid, Wiriyaporn; Angsuwatcharakon, Phonthep; Ratanachu-ek, Thawee; Rerknimitr, Rungsun
• Is Part Of: Gut. Volume 68(2019)Supplement 1
• Page Start: A4
• Page End: A5
• Publication Date: 2019-06
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2019-IDDFAbstracts.8
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Background: Combination of ERCP and EUS-BD (CERES) including EUS-guided hepaticogastrostomy (EUS-HGS) and EUS-guided hepaticoduodenostomy (EUS-HDS) may provide complete BD in bismuth 3 and 4 malignant hilar biliary obstruction (MHBO. This study aims to prospectively compare the efficacy of CERES versus PTBD in MHBO. Methods: Patients with MHBO were recruited. Patients presented to endoscopy and interventional radiology service received CERES (group A) and PTBD (group B) as primary BD method, respectively. Technical and clinical success rate (TSR and CSR) and time to RBO (T-RBO = time from last successful BD to biliary reintervention procedure) were recorded. The study was conducted during March 2016 until October 2018 as a multicenter study of 3 Thai hospitals (King Chulalongkorn Memorial Hospital of Thai Red Cross Society, Tha-Bor Hospital, and Roi-Et Hospital) under the Thai Association for Gastrointestinal Endoscopy (TAGE) guidance. Results: 45 patients (23M, 22F) were recruited into group A (n=23) and group B (n=22). One patient from group A was withdrawn due to loss to follow up. Demographic data and results of both groups are shown in table 1 . Overall TSR, CSR, and complication rate (CR) of group A versus B were 90.9% (20/22) vs 100% (22/22) (p=not significant (NS)), 81.8% (18/22) vs 86.4 (19/22) (p=NS), and 18.2 (4/22) vs 9.1 (2/22) (p=NS), respectively (table 1 ). Group A had significantly longer mean T-RBO than group B (168.4 ± 135.0 vs 51.8 ± 27.7 days, respectively; p=0.045). At the 6-month interval, the median number of biliary reintervention procedures in group A was significantly lower than group B (0; IQR 0–1 vs 2.5; IQR 2–5), respectively; p=0.001). The death rate at the 2-year interval of group A and B was 100% (16/16) and 93.8% (15/16) (p=NS), respectively (table 1 ). Conclusions: For BD in MHBO, based on results of this study, CERES provided longer patency with less frequent of RBO at 6-month interval.