ISSN ONLINE: 2558-815X
ISSN PRINT: 1584-9244
ISSN-L: 1584-9244

Management of suspected malignant biliary obstruction with same session EUS/ERCP – retrospective study of a single center experience


Introduction. Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are the two key players in the management of patients with pancreatobiliary diseases. The development of different equipment and new techniques leads to their evolvement not only for diagnosis but as a minimally invasive therapeutic modality. Combining the two techniques in a single session allows the rapid tissue acquisition, evaluation of surgical candidates, and drainage.
The objective of the study was to evaluate the advantages of single session ERCP and EUS as a faster management of jaundiced patient with suspected malignant obstruction, having one single sedation for both diagnosis and therapeutic management, shortening the hospital stay and cost while preserving patients’ outcomes. Our primary endpoints were diagnostic sensitivity and successful biliary drainage. The secondary endpoints were the adverse events evaluation and overall procedure time.
Material and methods. We performed a retrospective analysis of patients who underwent same session EUS with fine needle biopsy (FNB) /ERCP for presumed malignant biliary obstruction in a single tertiary center, between January 2021 – September 2022.
Results. We found a high diagnostic sensitivity of the method, in 94.17 % of the patients the pathologist confirmed the diagnosis of malignant biliary obstruction, with adequacy of the sample 95.83%. In all patients, adequate biliary drainage was performed in the same session, 93.3% only by ERCP.
Conclusions. Single session EUS-FNB/ERCP is an effective and safe approach in jaundiced patients with suspected malignant biliary obstruction, with the advantages of shorter hospital stay, less sedation-related risks and rapid patient management.
Keywords: endoscopic retrograde cholangiopancreatography, endoscopic ultrasound, pancreatic cancer.

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Karagyozov P, Petkova Y, Draganov K. Management of suspected malignant biliary obstruction with same session EUS/ERCP – retrospective study of a single center experience. Arch Balk Med Union. 2023;58(2):113-120.