Year 2025 / Volume 117 / Number 5
Letter
Is endoscopic retrograde cholangiopancreatography still the elective primary biliary drainage technique in patients with malignant distal biliary obstruction? Response to García-Cano et al.

290

DOI: 10.17235/reed.2024.10380/2024

Juan J. Vila, Vanesa Jusué Irurita, María Rullán Iriarte,

Abstract
We have read the letter from García-Cano et al. regarding our Editorial and are very grateful for the response as it contributes to deepening the debate we aim to generate on the topic. We are aware that changing a paradigm is always difficult, takes years, and requires publication of good quality studies. However, the way to progress in medicine and provide the best for patients involves questioning existing paradigms and considering the possibility of changing them. Currently, the outcomes of endoscopic ultrasonography guided transmural biliary drainage (EUS-TBD) have been progressively improving and the rate of adverse events (AE) has considerably decreased. The data currently available suggest that primary EUS-TBD in a specific setting is not inferior to ERCP drainage and may even entail a lower rate of AE.
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References
1. García-Cano J, Viñuelas M, Valiente L. Endoscopic drainage of malignant distal biliary obstruction. Will ERCP no longer be necessary? Rev Esp Enferm Dig 2024 (in press)
2. Vila Juan J., Jusué Irurita Vanesa, Rullán Iriarte María. Is ERCP still the elective primary biliary drainage technique in patients with malignant distal biliary obstruction? Rev Esp Enferm Dig 2023. doi: 10.17235/reed.2023.10029/2023.
3. Giri S, Mohan BP, Jearth V. et al. Adverse events with endoscopic-ultrasound guided biliary drainage: a systematic review and meta-analysis. Gastrointest Endosc 2023; 98: 515-523.e18.
4. Geyl S, Redelsperger B, Yzet C. et al. Risk factors for stent dysfunction during long-term follow-up after EUS-guided biliary drainage using lumen-apposing metal stents: a prospective study. Endosc Ultrasound 2023; 12: 237-244.
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(7):987-97. DOI: 10.1038/s41395-018-0122-8
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Vila J, Jusué Irurita V, Rullán Iriarte M. Is endoscopic retrograde cholangiopancreatography still the elective primary biliary drainage technique in patients with malignant distal biliary obstruction? Response to García-Cano et al.. 10380/2024


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Publication history

Received: 02/03/2024

Accepted: 08/03/2024

Online First: 12/03/2024

Published: 08/05/2025

Article Online First time: 10 days

Article editing time: 432 days


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