Endosonography-guided cholangiopancreatography as a salvage drainage procedure for obstructed biliary and pancreatic ducts

Table 1 The nine different ESCP approaches as defined by the first 39 patients reported from 9 institutions

	Transpapillary		Transmural
	Rendezvous	Antegrade
Pancreatic duct	1 Bataille et al[11]	2 Kahaleh et al[13]	4 François et al[12]
	4 Mallery et al[16]
	1 DeWitt et al*[18]
	1 Will et al[22]
Intrahepatic bile duct	5 Kahaleh et al[21]	1 Puspok et al[20]	2 Burmester et al[15]
			1 Giovannini et al[10]
Extrahepatic bile duct	2 Mallery et al[16]	1 Puspok et al[20]	1 Giovannini et al[14]
	1 Lai et al[19]		2 Burmester et al[15]
	4 Kahaleh et al[17]		4 Puspok et al[20]
			1 Kahaleh et al[17]
			1 Kahaleh et al[21]

Numbers before each author’s name express number of patients reported with a given individual ESCP approach by the author in the referenced article. A total of 19 patients were drained by transpapillary ESCP rendezvous (7 pancreatic, 12 biliary) and 16 transmurally (4 pancreatic, 12 biliary). The dominant approaches were pancreatic rendezvous (7 patients from 4 centers) and chole-dochoduodenstomy (9 patients from 4 centers). ^*Methylene-blue EUS-guided pancreatography with subsequent non rendezvous ERCP.

Table 2 Major series on EUS-guided biliary drainage

Year	Author	n (malignant/benign)	Access route	Drainage success - Drainage route	Complications
2009	Horaguchi[35]	16 (15/1)	8 EH 8 IH	15/16 (94%) - 8 TD - 6 TG - 2 TE	2 (12. 50%) - 1 bile peritonitis - 1 stent migration
2009	Brauer[26]	12 (8/4)	12 EH	11/12 (92%) - 7 TP - 4 TD	2 (10%) - 1 pneumoperitoneum and peritonitis - 1 cardiopulmonary failure
2009	Maranki[25]	49 (35/14)	35 IH 14 EH	Overall: 41/49 (84%)	Total: 8 (16%) IH: 5/35 (14%) - pneumoperitoneum (3) - bleeding (1), - pneumonia (1) EH: 3/14 (21%) - bile peritonitis (1) - pain (1) - pneumoperitoneum (1)
				IH: 29/40 (73%) - 26 TP, 3 TG
				EH: 12/14 (86%) - 8 TP, 4 TD
2008	Tarantino[24]	8 (7/1)	9 EH	8/8 (100%) - 4 TP, 4 TD	Not procedure related - 1 death after 15 d (hepatic failure, cirrhosis)
2008	Yamao[32]	5 (5/0)	5 EH	5/5 (100%) - 5 TD	1 (20%) - pneumoperitoneum
2008	Itoi[33]	4 (4/0)	4 EH	4/4 (100%) - 4 TD	1 (25%) - bleeding and bile peritonitis
2007	Bories[30]	11 (8/3)	11 IH	10/11 (91%) - 10 TG	4 (36%) - ileus - early stent occlusion - biloma - cholangitis
2007	Will[31]	8 (7/1)	8 IH	6/8 (75%) - 1 TE, 4 TG, 3 TJ	2 (25%) - cholangitis, pain
2005	Püspök[20]	6 (4/2)	5 EH 1 IH	5/6 (83%) - 3 TB, 1 TD, 1 TJ	1 (17%) - cholecystitis
2003	Burmester[15]	4 (4/0)	2 EH 2 IH	3/4 (75%) - 1 TD, 2 TJ, 1 TG	1 (25%) - cholangitis, sepsis death (failed procedure)

TG: Transgastric; TD: Transduodenal, TP: Transpapillary; TE: Transesophageal; TJ: Transjejunal; EH: Extrahepatic; IH: Intrahepatic.

Table 3 Major series on EUS-guided pancreatic duct drainage

Year	Author	N	Access route	Technical success - Drainage route	Clinical success	Complications
2009	Brauer[26]	8	TG – TD	7/8 (88%) - 3 TG, 1 TD, 3 TP	4/8 (50%)	No complications - Pain evaluation: non significant improvement
2007	Tessier[43]	36	29 TG 7 TD	33/36 (92%) - 26 TG, 7 TD	25/36 (69%)	5 (13%) - 2 severe (5%): hematoma, pancreatitis - 3 mild (8%)
					Total or significant pain relief	Stent dysfunction: 20 pt (55%) = 29 new endoscopic procedures
2007	Kahaleh[44]	13	13 TG	10/13 (77%) - 10 TG	10/13 (77%) < score pain < pancreatic duct diameter = narcotic use	2 (15%) - bleeding, perforation
2007	Will[45]	12	12 TG	9/12 (75%) - 5 TG, 4 TP	- 5 pt (42%): pain relief, fistula closure - 4 pt: surgery - 3 pt: endoscopy	6 (43%) - 2 severe (14%): bleeding, perforation - 4 mild (29%): pain
2004	Mallery[16]	4	4 TG	1/4 (25%) - TP	1/4 (25%)	2 (50%) - mild pancreatitis - fever
2002	Francoise[12]	4	4 TG	4/4 (100%)	3/4 (75%)	No complications

TG: Transgastric; TD: Transduodenal; TP: Transpapillary.