Contribution of EUS-guided biliary drainage for endoscopic palliation of Bilioduodenum pancreatic confluent cancer.

• Grant number: 11/11725-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: August 01, 2011
• End date: July 31, 2012
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Everson Luiz de Almeida Artifon
• Grantee: Carolina Rebello da Costa
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Retrograde endoscopic cholangiopancreatography (RECP) with the objective of biliary drainage is considered "gold standard" for effective drainage of obstructed bile duct, resulting in a success rate of 90 to 95%. However, there are several anatomical variations that may lead to failure of this procedure. For these cases, alternatives would be the repetition of RECP, percutaneous transhepatic drainage and surgical procedure. Percutaneous transhepatic drainage presents a complication rate around 32%. The surgery, considered the definitive procedure, is associated with high rates of morbidity and mortality, longer time of internatio, therefore causing a reduction of the life quality of the patiants and highier risks associated with hospital infections.Considering the reports regarding the pass of USG guided transmural prosthesis through the left hepatic duct or distal common bile duct, the reported success rate is 90% in the first and 80% the second. There are minor complications (bleeding on the puncture site and distal migration of the prosthesis) in 20% of USG-Guided biliary drainage, 6% major complications such as formation of bile collection. Thus, this method of biliary drainage have accumulated credibility as an alternative to external transhepatic biliary drainage and even surgery. Thus, considering that USG guided biliary drainage is minimally invasive and has low complication rates, we propose a prospective study of 15 cases of malignant tumor patients with obstruction of the biliary tree, without a successful attempt by internal biliary drainage prior to RECP. Technical data will be checked for success, complications and impact on quality of life using the SF-36 index and considering the length of hospital stay. The data will be compiled, analyzed and the results published as an object of scientific initiation.