Wu SZ. Endoscopic ultrasound-guided biliary drainage using electrocautery-enhanced lumen-apposing metal stent for malignant biliary obstruction: A promising procedure. World J Clin Cases 2024; 12(26): 5859-5862 [PMID: 39286387 DOI: 10.12998/wjcc.v12.i26.5859]
Corresponding Author of This Article
Si-Ze Wu, MD, Chief Physician, Professor, Department of Ultrasound, The First Affiliated Hospital of Hainan Medical University, No. 31 Longhua Road, Haikou 570102, Hainan Province, China. wsz074@aliyun.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 16, 2024; 12(26): 5859-5862 Published online Sep 16, 2024. doi: 10.12998/wjcc.v12.i26.5859
Endoscopic ultrasound-guided biliary drainage using electrocautery-enhanced lumen-apposing metal stent for malignant biliary obstruction: A promising procedure
Si-Ze Wu
Si-Ze Wu, Department of Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou 570102, Hainan Province, China
Author contributions: Wu SZ conceptualized and wrote the manuscript.
Conflict-of-interest statement: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Si-Ze Wu, MD, Chief Physician, Professor, Department of Ultrasound, The First Affiliated Hospital of Hainan Medical University, No. 31 Longhua Road, Haikou 570102, Hainan Province, China. wsz074@aliyun.com
Received: April 20, 2024 Revised: May 19, 2024 Accepted: June 7, 2024 Published online: September 16, 2024 Processing time: 94 Days and 4.5 Hours
Abstract
In this editorial, we comment on the article by Peng et al. Palliative drainage for biliary obstruction resulting from unresectable malignant lesions includes internal and external drainage. The procedures of biliary drainage are usually guided by fluoroscopy or transcutaneous ultrasound, endoscopic ultrasound (EUS), or both. Endoscopic retrograde cholangiopancreatography (ERCP) has been primarily recommended for the management of biliary obstruction, while EUS-guided biliary drainage and percutaneous transhepatic biliary drainage (PTBD) are alternative choices for cases where ERCP has failed or is impossible. PTBD is limited by shortcomings of a higher rate of adverse events, more reinterventions, and severe complications. EUS-guided biliary drainage has a lower rate of adverse events than PTBD. EUS-guided biliary drainage with electrocautery-enhanced lumen-apposing metal stent (ECE-LAMS) enables EUS-guided biliary-enteric anastomosis to be performed in a single step and does not require prior bile duct puncture or a guidewire. The present meta-analysis showed that ECE-LAMS has a high efficacy and safety in relieving biliary obstruction in general, although the results of LAMS depending on the site of biliary obstruction. This study has highlighted the latest advances with a larger sample-based comprehensive analysis.
Core Tip: Some malignant distal biliary obstructions require drainage for palliative treatment, and endoscopic retrograde cholangiopancreatography (ERCP) with placement of a stent has been a first choice. However, ERCP can fail or may not be suitable for some challenging cases. Endoscopic ultrasound (EUS)-guided biliary drainage with electrocautery-enhanced lumen-apposing metal stent can be an alternative choice for ERCP, with the strength to perform biliary-enteric anastomosis under EUS guidance in a single step without the need for prior bile duct puncture or a guidewire. In this editorial, the efficacy and safety of it have been discussed, and the latest advances are highlighted.
