第2回 内視鏡的胆管ドレナージ～内視鏡医の立場から
内視鏡的胆道ドレナージについて，内視鏡医の立場からドレナージ法に対する考え方，手技，ドレナージ困難例に対する対応などについて述べた．胆管癌による胆管狭窄に対するゴールドスタンダードは内視鏡的胆管ドレナージであり，考え方やその対応が他癌とは異なることを解説した．最近では，超音波内視鏡を用いたドレナージが開発され，広く応用されているため，その手技についても解説した．しかし，少なくとも現状では，胆道癌の胆管ドレナージにおいて超音波内視鏡下胆道ドレナージがfirst lineになるのは難しいことも解説した．胆管ドレナージはあくまで姑息的治療であり治療の本質とは異なるため，がん治療全体を見据えた治療戦略...
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| Published in | 胆道 Vol. 34; no. 2; pp. 237 - 243 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本胆道学会
31.05.2020
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0914-0077 1883-6879 |
| DOI | 10.11210/tando.34.237 |
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| Abstract | 内視鏡的胆道ドレナージについて，内視鏡医の立場からドレナージ法に対する考え方，手技，ドレナージ困難例に対する対応などについて述べた．胆管癌による胆管狭窄に対するゴールドスタンダードは内視鏡的胆管ドレナージであり，考え方やその対応が他癌とは異なることを解説した．最近では，超音波内視鏡を用いたドレナージが開発され，広く応用されているため，その手技についても解説した．しかし，少なくとも現状では，胆道癌の胆管ドレナージにおいて超音波内視鏡下胆道ドレナージがfirst lineになるのは難しいことも解説した．胆管ドレナージはあくまで姑息的治療であり治療の本質とは異なるため，がん治療全体を見据えた治療戦略をもってドレナージを行うべきであることを強調した． |
|---|---|
| AbstractList | 内視鏡的胆道ドレナージについて，内視鏡医の立場からドレナージ法に対する考え方，手技，ドレナージ困難例に対する対応などについて述べた．胆管癌による胆管狭窄に対するゴールドスタンダードは内視鏡的胆管ドレナージであり，考え方やその対応が他癌とは異なることを解説した．最近では，超音波内視鏡を用いたドレナージが開発され，広く応用されているため，その手技についても解説した．しかし，少なくとも現状では，胆道癌の胆管ドレナージにおいて超音波内視鏡下胆道ドレナージがfirst lineになるのは難しいことも解説した．胆管ドレナージはあくまで姑息的治療であり治療の本質とは異なるため，がん治療全体を見据えた治療戦略をもってドレナージを行うべきであることを強調した． 内視鏡的胆道ドレナージについて, 内視鏡医の立場からドレナージ法に対する考え方, 手技, ドレナージ困難例に対する対応などについて述べた. 胆管癌による胆管狭窄に対するゴールドスタンダードは内視鏡的胆管ドレナージであり, 考え方やその対応が他癌とは異なることを解説した. 最近では, 超音波内視鏡を用いたドレナージが開発され, 広く応用されているため, その手技についても解説した. しかし, 少なくとも現状では, 胆道癌の胆管ドレナージにおいて超音波内視鏡下胆道ドレナージがfirst lineになるのは難しいことも解説した. 胆管ドレナージはあくまで姑息的治療であり治療の本質とは異なるため, がん治療全体を見据えた治療戦略をもってドレナージを行うべきであることを強調した. |
| Author | 原, 和生 清水, 泰博 羽場, 真 桑原, 崇通 孝田, 博輝 奥野, のぞみ |
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| DOI | 10.11210/tando.34.237 |
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| References | 4) Sharaiha RZ, Kumta NA, Desai AP, et al. Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage: predictors of successful outcome in patients who fail endoscopic retrograde cholangiopancreatography. Surg Endosc 2016; 30: 5500-5505 8) Hara K, Yamao K, Hijioka S, et al. Prospective clinical study of endoscopic ultrasound-guided choledochoduodenostomy with direct metallic stent placement using a forward-viewing echoendoscope. Endoscopy 2013; 45: 392-396 9) Okuno N, Hara K, Mizuno N, et al. Advanced technique for biliary stricture diagnosis using endoscopic ultrasound (EUS)-guided hepaticogastrostomy. Endoscopy 2017; 49: E60-E61 14) Ogura T, Sano T, Onda S, et al. Endoscopic ultrasound-guided biliary drainage for right hepatic bile duct obstruction: novel technical tips. Endoscopy 2015; 47: 72-75 25) Auriemma F, De Luca L, Bianchetti M, et al. Radiofrequency and malignant biliary strictures: An update. World J Gastrointest Endosc 2019; 11: 95-102 6) Hara K, Yamao K, Mizuno N, et al. Endoscopic ultrasonography-guided biliary drainage: Who, when, which, and how? World J Gastroenterol 2016; 22: 1297-1303 20) Sofi AA, Khan MA, Das A, et al. Radiofrequency ablation combined with biliary stent placement versus stent placement alone for malignant biliary strictures: a systematic review and meta-analysis. Gastrointest Endosc 2018; 87: 944-951 e1 21) Nayar MK, Oppong KW, Bekkali NLH, et al. Novel temperature-controlled RFA probe for treatment of blocked metal biliary stents in patients with pancreaticobiliary cancers: initial experience. Endosc Int Open 2018; 6: E513-E517 18) Park do H. Endoscopic ultrasound-guided biliary drainage of hilar biliary obstruction. J Hepatobiliary Pancreat Sci 2015; 22: 664-668 1) Testoni PA, Mariani A, Aabakken L, et al. Papillary cannulation and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2016; 48: 657-683 15) Minaga K, Takenaka M, Kitano M, et al. Rescue EUS-guided intrahepatic biliary drainage for malignant hilar biliary stricture after failed transpapillary re-intervention. Surg Endosc 2017; 31: 4764-4772 3) Lee TH, Choi JH, Park do H, et al. Similar Efficacies of Endoscopic Ultrasound-guided Transmural and Percutaneous Drainage for Malignant Distal Biliary Obstruction. Clin Gastroenterol Hepatol 2016; 14: 1011-1019 e3 11) Paik WH, Lee TH, Park DH, et al. Correction: EUS-Guided Biliary Drainage Versus ERCP for the Primary Palliation of Malignant Biliary Obstruction: A Multicenter Randomized Clinical Trial. Am J Gastroenterol 2018; 113: 987-997 12) Park JK, Woo YS, Noh DH, et al. Efficacy of EUS-guided and ERCP-guided biliary drainage for malignant biliary obstruction: prospective randomized controlled study. Gastrointest Endosc 2018; 88: 277-282 17) Ogura T, Onda S, Takagi W, et al. Clinical utility of endoscopic ultrasound-guided biliary drainage as a rescue of re-intervention procedure for high-grade hilar stricture. J Gastroenterol Hepatol 2017; 32: 163-168 23) Kadayifci A, Atar M, Forcione DG, et al. Radiofrequency ablation for the management of occluded biliary metal stents. Endoscopy 2016; 48: 1096-1101 22) Lee YN, Jeong S, Choi HJ, et al. The safety of newly developed automatic temperature-controlled endobiliary radiofrequency ablation system for malignant biliary strictures: A prospective multicenter study. J Gastroenterol Hepatol 2019; 34: 1454-1459 5) Paik WH, Lee TH, Park DH, et al. EUS-Guided Biliary Drainage Versus ERCP for the Primary Palliation of Malignant Biliary Obstruction: A Multicenter Randomized Clinical Trial. Am J Gastroenterol 2018; 113: 987-997 24) Han SY, Song GA, Kim DU, et al. Bile Duct Patency Maintained after Intraductal Radiofrequency Ablation in a Case of Hepatocellular Cholangiocarcinoma with Bile Duct Invasion. Clin Endosc 2018; 51: 201-205 10) Bang JY, Navaneethan U, Hasan M, et al. Stent placement by EUS or ERCP for primary biliary decompression in pancreatic cancer: a randomized trial (with videos). Gastrointest Endosc 2018; 88: 9-17 19) Yoshida T, Hara K, Imaoka H, et al. Benefits of side-by-side deployment of 6-mm covered self-expandable metal stents for hilar malignant biliary obstructions. J Hepatobiliary Pancreat Sci 2016; 23: 548-555 16) Moryoussef F, Sportes A, Leblanc S, et al. Is EUS-guided drainage a suitable alternative technique in case of proximal biliary obstruction? Therap Adv Gastroenterol 2017; 10: 537-544 2) Okuno N, Hara K, Mizuno N, et al. Efficacy of the 6-mm fully covered self-expandable metal stent during endoscopic ultrasound-guided hepaticogastrostomy as a primary biliary drainage for the cases estimated difficult endoscopic retrograde cholangiopancreatography: A prospective clinical study. J Gastroenterol Hepatol 2018; 33: 1413-1421 13) Park SJ, Choi JH, Park DH, et al. Expanding indication: EUS-guided hepaticoduodenostomy for isolated right intrahepatic duct obstruction (with video). Gastrointest Endosc 2013; 78: 374-380 7) Hara K, Okuno N, Yamao K. De novo EUS-guided biliary drainage. Endosc Ultrasound 2019; 8: S14-S16 |
| References_xml | – reference: 15) Minaga K, Takenaka M, Kitano M, et al. Rescue EUS-guided intrahepatic biliary drainage for malignant hilar biliary stricture after failed transpapillary re-intervention. Surg Endosc 2017; 31: 4764-4772 – reference: 21) Nayar MK, Oppong KW, Bekkali NLH, et al. Novel temperature-controlled RFA probe for treatment of blocked metal biliary stents in patients with pancreaticobiliary cancers: initial experience. Endosc Int Open 2018; 6: E513-E517 – reference: 19) Yoshida T, Hara K, Imaoka H, et al. Benefits of side-by-side deployment of 6-mm covered self-expandable metal stents for hilar malignant biliary obstructions. J Hepatobiliary Pancreat Sci 2016; 23: 548-555 – reference: 12) Park JK, Woo YS, Noh DH, et al. Efficacy of EUS-guided and ERCP-guided biliary drainage for malignant biliary obstruction: prospective randomized controlled study. Gastrointest Endosc 2018; 88: 277-282 – reference: 5) Paik WH, Lee TH, Park DH, et al. EUS-Guided Biliary Drainage Versus ERCP for the Primary Palliation of Malignant Biliary Obstruction: A Multicenter Randomized Clinical Trial. Am J Gastroenterol 2018; 113: 987-997 – reference: 13) Park SJ, Choi JH, Park DH, et al. Expanding indication: EUS-guided hepaticoduodenostomy for isolated right intrahepatic duct obstruction (with video). Gastrointest Endosc 2013; 78: 374-380 – reference: 16) Moryoussef F, Sportes A, Leblanc S, et al. Is EUS-guided drainage a suitable alternative technique in case of proximal biliary obstruction? Therap Adv Gastroenterol 2017; 10: 537-544 – reference: 9) Okuno N, Hara K, Mizuno N, et al. Advanced technique for biliary stricture diagnosis using endoscopic ultrasound (EUS)-guided hepaticogastrostomy. Endoscopy 2017; 49: E60-E61 – reference: 2) Okuno N, Hara K, Mizuno N, et al. Efficacy of the 6-mm fully covered self-expandable metal stent during endoscopic ultrasound-guided hepaticogastrostomy as a primary biliary drainage for the cases estimated difficult endoscopic retrograde cholangiopancreatography: A prospective clinical study. J Gastroenterol Hepatol 2018; 33: 1413-1421 – reference: 20) Sofi AA, Khan MA, Das A, et al. Radiofrequency ablation combined with biliary stent placement versus stent placement alone for malignant biliary strictures: a systematic review and meta-analysis. Gastrointest Endosc 2018; 87: 944-951 e1 – reference: 17) Ogura T, Onda S, Takagi W, et al. Clinical utility of endoscopic ultrasound-guided biliary drainage as a rescue of re-intervention procedure for high-grade hilar stricture. J Gastroenterol Hepatol 2017; 32: 163-168 – reference: 10) Bang JY, Navaneethan U, Hasan M, et al. Stent placement by EUS or ERCP for primary biliary decompression in pancreatic cancer: a randomized trial (with videos). Gastrointest Endosc 2018; 88: 9-17 – reference: 14) Ogura T, Sano T, Onda S, et al. Endoscopic ultrasound-guided biliary drainage for right hepatic bile duct obstruction: novel technical tips. Endoscopy 2015; 47: 72-75 – reference: 25) Auriemma F, De Luca L, Bianchetti M, et al. Radiofrequency and malignant biliary strictures: An update. World J Gastrointest Endosc 2019; 11: 95-102 – reference: 1) Testoni PA, Mariani A, Aabakken L, et al. Papillary cannulation and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2016; 48: 657-683 – reference: 18) Park do H. Endoscopic ultrasound-guided biliary drainage of hilar biliary obstruction. J Hepatobiliary Pancreat Sci 2015; 22: 664-668 – reference: 3) Lee TH, Choi JH, Park do H, et al. Similar Efficacies of Endoscopic Ultrasound-guided Transmural and Percutaneous Drainage for Malignant Distal Biliary Obstruction. Clin Gastroenterol Hepatol 2016; 14: 1011-1019 e3 – reference: 7) Hara K, Okuno N, Yamao K. De novo EUS-guided biliary drainage. Endosc Ultrasound 2019; 8: S14-S16 – reference: 8) Hara K, Yamao K, Hijioka S, et al. Prospective clinical study of endoscopic ultrasound-guided choledochoduodenostomy with direct metallic stent placement using a forward-viewing echoendoscope. Endoscopy 2013; 45: 392-396 – reference: 24) Han SY, Song GA, Kim DU, et al. Bile Duct Patency Maintained after Intraductal Radiofrequency Ablation in a Case of Hepatocellular Cholangiocarcinoma with Bile Duct Invasion. Clin Endosc 2018; 51: 201-205 – reference: 4) Sharaiha RZ, Kumta NA, Desai AP, et al. Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage: predictors of successful outcome in patients who fail endoscopic retrograde cholangiopancreatography. Surg Endosc 2016; 30: 5500-5505 – reference: 22) Lee YN, Jeong S, Choi HJ, et al. The safety of newly developed automatic temperature-controlled endobiliary radiofrequency ablation system for malignant biliary strictures: A prospective multicenter study. J Gastroenterol Hepatol 2019; 34: 1454-1459 – reference: 11) Paik WH, Lee TH, Park DH, et al. Correction: EUS-Guided Biliary Drainage Versus ERCP for the Primary Palliation of Malignant Biliary Obstruction: A Multicenter Randomized Clinical Trial. Am J Gastroenterol 2018; 113: 987-997 – reference: 23) Kadayifci A, Atar M, Forcione DG, et al. Radiofrequency ablation for the management of occluded biliary metal stents. Endoscopy 2016; 48: 1096-1101 – reference: 6) Hara K, Yamao K, Mizuno N, et al. Endoscopic ultrasonography-guided biliary drainage: Who, when, which, and how? World J Gastroenterol 2016; 22: 1297-1303 |
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| Snippet | ... 内視鏡的胆道ドレナージについて, 内視鏡医の立場からドレナージ法に対する考え方, 手技, ドレナージ困難例に対する対応などについて述べた. 胆管癌による胆管狭窄に対するゴールドスタンダードは内視鏡的胆管ドレナージであり, 考え方やその対応が他癌とは異なることを解説した. 最近では,... |
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| SubjectTerms | ERCP 内視鏡的胆道ドレナージ 胆道癌 超音波内視鏡 超音波内視鏡下胆道ドレナージ |
| Title | 第2回 内視鏡的胆管ドレナージ～内視鏡医の立場から |
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