Endoscopic ultrasound-guided choledochoduodenostomy results in fewer complications than percutaneous drainage following failed ERCP in malignant distal biliary obstruction

Mike J.P. De Jong; Foke Van Delft; Erwin Jan M. Van Geenen; Auke Bogte; Robert C. Verdonk; Niels G. Venneman; Jan Maarten Vrolijk; Jan Willem A. Straathof; Rogier P. Voermans; Rina A. Bijlsma; Sjoerd D. Kuiken; Rutger Quispel; Muhammed Hadithi; Kirill Basiliya; Frank P. Vleggaar; Tanya M. Bisseling; Thomas R. De Wijkerslooth; Marco J. Bruno; Roy L.J. Van Wanrooij; Peter D. Siersema

doi:10.1055/a-2580-1316

Endoscopic ultrasound-guided choledochoduodenostomy results in fewer complications than percutaneous drainage following failed ERCP in malignant distal biliary obstruction

Mike J.P. De Jong^*
, Foke Van Delft
, Erwin Jan M. Van Geenen
, Auke Bogte
, Robert C. Verdonk
, Niels G. Venneman
, Jan Maarten Vrolijk
, Jan Willem A. Straathof
, Rogier P. Voermans
, Rina A. Bijlsma
, Sjoerd D. Kuiken
, Rutger Quispel
, Muhammed Hadithi
, Kirill Basiliya
, Frank P. Vleggaar
, Tanya M. Bisseling
, Thomas R. De Wijkerslooth
, Marco J. Bruno
, Roy L.J. Van Wanrooij
, Peter D. Siersema

^*Corresponding author for this work

Gastroenterology & Hepatology

Radboud University Medical Center
St. Antonius Ziekenhuis
Utrecht University
Medisch Spectrum Twente
Rijnstate Hospital
Maxima Medical Centre
University of Amsterdam
Martini Ziekenhuis
Onze Lieve Vrouwe Gasthuis
Renier de Graaf Gasthuis
Maasstad Hospital
Leiden University
Netherlands Cancer Institute
VU University Medical Center

Research output: Contribution to journal › Article › Academic › peer-review

12 Citations (Scopus)

4 Downloads (Pure)

Abstract

Background:

Percutaneous transhepatic biliary drainage (PTBD) and endoscopic ultrasound-guided biliary drainage (EUS-BD), including choledochoduodenostomy (EUS-CDS), are alternative methods for biliary drainage in patients with distal malignant biliary obstruction (MBO) after failed endoscopic retrograde cholangiopancreatography (ERCP). Data on long-term outcomes, adverse events (AEs), and quality of life (QoL) after EUS-CDS and PTBD are limited. Therefore, we created a registry to evaluate the outcomes of both drainage procedures.

Methods:

Patients with distal MBO who underwent EUS CDS or PTBD after unsuccessful ERCP were included in this multicenter investigator-initiated prospective registry over an 18-month inclusion period. Primary end points were procedure-related AEs and mortality within 90 days post procedure. Secondary end points included technical and clinical success, reinterventions, hospital stay, and QoL.

Results:

55patients wereincluded, with 12patients under going PTBD (technical success 100%) and 43 patients EUS CDS (technical success 97.7%). Prior to ERCP, 7/12 patients in the PTBDgroupand12/43patientsintheEUS-CDSgroup opted for best supportive care. The 90-day mortality rate was 66.7% in the PTBD group and 20.9% in the EUS-CDS group (P=0.005). Furthermore, 11/12 patients (91.7%) in the PTBD group and 19/43 (44.2%) in the EUS-CDS group developed one or more AEs (P=0.004). The median post procedural hospital stay was 4 days (interquartile range [IQR] 2-6) in the PTBD group vs. 1 day (IQR 1-2) in the EUS-CDS group (P=0.001).

Conclusion:

When both modalities were available and technically feasible, gastroenterologists preferred EUS-CDS over PTBD. EUS-CDS seems to be associated with lower mortality and AErates, shorter hospital admission, and few er reinterventions, but a randomized controlled trial should confirm these observations.

Original language	English
Pages (from-to)	1004-1015
Number of pages	12
Journal	Endoscopy
Volume	57
Issue number	9
DOIs	https://doi.org/10.1055/a-2580-1316
Publication status	Published - 28 Aug 2025

Bibliographical note

Publisher Copyright:
© 2025. The Author(s).

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Endoscopic ultrasound-guided choledochoduodenostomy results in fewer complications than percutaneous drainage following failed ERCP in malignant distal biliary obstructionFinal published version, 1.05 MBLicence: CC BY

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De Jong, M. J. P., Van Delft, F., Van Geenen, E. J. M., Bogte, A., Verdonk, R. C., Venneman, N. G., Vrolijk, J. M., Straathof, J. W. A., Voermans, R. P., Bijlsma, R. A., Kuiken, S. D., Quispel, R., Hadithi, M., Basiliya, K., Vleggaar, F. P., Bisseling, T. M., De Wijkerslooth, T. R., Bruno, M. J., Van Wanrooij, R. L. J., & Siersema, P. D. (2025). Endoscopic ultrasound-guided choledochoduodenostomy results in fewer complications than percutaneous drainage following failed ERCP in malignant distal biliary obstruction. Endoscopy, 57(9), 1004-1015. https://doi.org/10.1055/a-2580-1316

@article{9d87a7fb31244cf2b05e3c0f24bd63b3,

title = "Endoscopic ultrasound-guided choledochoduodenostomy results in fewer complications than percutaneous drainage following failed ERCP in malignant distal biliary obstruction",

abstract = "Background:Percutaneous transhepatic biliary drainage (PTBD) and endoscopic ultrasound-guided biliary drainage (EUS-BD), including choledochoduodenostomy (EUS-CDS), are alternative methods for biliary drainage in patients with distal malignant biliary obstruction (MBO) after failed endoscopic retrograde cholangiopancreatography (ERCP). Data on long-term outcomes, adverse events (AEs), and quality of life (QoL) after EUS-CDS and PTBD are limited. Therefore, we created a registry to evaluate the outcomes of both drainage procedures. Methods:Patients with distal MBO who underwent EUS CDS or PTBD after unsuccessful ERCP were included in this multicenter investigator-initiated prospective registry over an 18-month inclusion period. Primary end points were procedure-related AEs and mortality within 90 days post procedure. Secondary end points included technical and clinical success, reinterventions, hospital stay, and QoL. Results:55patients wereincluded, with 12patients under going PTBD (technical success 100\%) and 43 patients EUS CDS (technical success 97.7\%). Prior to ERCP, 7/12 patients in the PTBDgroupand12/43patientsintheEUS-CDSgroup opted for best supportive care. The 90-day mortality rate was 66.7\% in the PTBD group and 20.9\% in the EUS-CDS group (P=0.005). Furthermore, 11/12 patients (91.7\%) in the PTBD group and 19/43 (44.2\%) in the EUS-CDS group developed one or more AEs (P=0.004). The median post procedural hospital stay was 4 days (interquartile range [IQR] 2-6) in the PTBD group vs. 1 day (IQR 1-2) in the EUS-CDS group (P=0.001). Conclusion:When both modalities were available and technically feasible, gastroenterologists preferred EUS-CDS over PTBD. EUS-CDS seems to be associated with lower mortality and AErates, shorter hospital admission, and few er reinterventions, but a randomized controlled trial should confirm these observations.",

author = "\{De Jong\}, \{Mike J.P.\} and \{Van Delft\}, Foke and \{Van Geenen\}, \{Erwin Jan M.\} and Auke Bogte and Verdonk, \{Robert C.\} and Venneman, \{Niels G.\} and Vrolijk, \{Jan Maarten\} and Straathof, \{Jan Willem A.\} and Voermans, \{Rogier P.\} and Bijlsma, \{Rina A.\} and Kuiken, \{Sjoerd D.\} and Rutger Quispel and Muhammed Hadithi and Kirill Basiliya and Vleggaar, \{Frank P.\} and Bisseling, \{Tanya M.\} and \{De Wijkerslooth\}, \{Thomas R.\} and Bruno, \{Marco J.\} and \{Van Wanrooij\}, \{Roy L.J.\} and Siersema, \{Peter D.\}",

note = "Publisher Copyright: {\textcopyright} 2025. The Author(s).",

year = "2025",

month = aug,

day = "28",

doi = "10.1055/a-2580-1316",

language = "English",

volume = "57",

pages = "1004--1015",

journal = "Endoscopy",

issn = "0013-726X",

publisher = "Georg Thieme Verlag",

number = "9",

}

De Jong, MJP, Van Delft, F, Van Geenen, EJM, Bogte, A, Verdonk, RC, Venneman, NG, Vrolijk, JM, Straathof, JWA, Voermans, RP, Bijlsma, RA, Kuiken, SD, Quispel, R, Hadithi, M, Basiliya, K, Vleggaar, FP, Bisseling, TM, De Wijkerslooth, TR, Bruno, MJ, Van Wanrooij, RLJ & Siersema, PD 2025, 'Endoscopic ultrasound-guided choledochoduodenostomy results in fewer complications than percutaneous drainage following failed ERCP in malignant distal biliary obstruction', Endoscopy, vol. 57, no. 9, pp. 1004-1015. https://doi.org/10.1055/a-2580-1316

Endoscopic ultrasound-guided choledochoduodenostomy results in fewer complications than percutaneous drainage following failed ERCP in malignant distal biliary obstruction. / De Jong, Mike J.P.; Van Delft, Foke; Van Geenen, Erwin Jan M. et al.
In: Endoscopy, Vol. 57, No. 9, 28.08.2025, p. 1004-1015.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Endoscopic ultrasound-guided choledochoduodenostomy results in fewer complications than percutaneous drainage following failed ERCP in malignant distal biliary obstruction

AU - De Jong, Mike J.P.

AU - Van Delft, Foke

AU - Van Geenen, Erwin Jan M.

AU - Bogte, Auke

AU - Verdonk, Robert C.

AU - Venneman, Niels G.

AU - Vrolijk, Jan Maarten

AU - Straathof, Jan Willem A.

AU - Voermans, Rogier P.

AU - Bijlsma, Rina A.

AU - Kuiken, Sjoerd D.

AU - Quispel, Rutger

AU - Hadithi, Muhammed

AU - Basiliya, Kirill

AU - Vleggaar, Frank P.

AU - Bisseling, Tanya M.

AU - De Wijkerslooth, Thomas R.

AU - Bruno, Marco J.

AU - Van Wanrooij, Roy L.J.

AU - Siersema, Peter D.

PY - 2025/8/28

Y1 - 2025/8/28

N2 - Background:Percutaneous transhepatic biliary drainage (PTBD) and endoscopic ultrasound-guided biliary drainage (EUS-BD), including choledochoduodenostomy (EUS-CDS), are alternative methods for biliary drainage in patients with distal malignant biliary obstruction (MBO) after failed endoscopic retrograde cholangiopancreatography (ERCP). Data on long-term outcomes, adverse events (AEs), and quality of life (QoL) after EUS-CDS and PTBD are limited. Therefore, we created a registry to evaluate the outcomes of both drainage procedures. Methods:Patients with distal MBO who underwent EUS CDS or PTBD after unsuccessful ERCP were included in this multicenter investigator-initiated prospective registry over an 18-month inclusion period. Primary end points were procedure-related AEs and mortality within 90 days post procedure. Secondary end points included technical and clinical success, reinterventions, hospital stay, and QoL. Results:55patients wereincluded, with 12patients under going PTBD (technical success 100%) and 43 patients EUS CDS (technical success 97.7%). Prior to ERCP, 7/12 patients in the PTBDgroupand12/43patientsintheEUS-CDSgroup opted for best supportive care. The 90-day mortality rate was 66.7% in the PTBD group and 20.9% in the EUS-CDS group (P=0.005). Furthermore, 11/12 patients (91.7%) in the PTBD group and 19/43 (44.2%) in the EUS-CDS group developed one or more AEs (P=0.004). The median post procedural hospital stay was 4 days (interquartile range [IQR] 2-6) in the PTBD group vs. 1 day (IQR 1-2) in the EUS-CDS group (P=0.001). Conclusion:When both modalities were available and technically feasible, gastroenterologists preferred EUS-CDS over PTBD. EUS-CDS seems to be associated with lower mortality and AErates, shorter hospital admission, and few er reinterventions, but a randomized controlled trial should confirm these observations.

AB - Background:Percutaneous transhepatic biliary drainage (PTBD) and endoscopic ultrasound-guided biliary drainage (EUS-BD), including choledochoduodenostomy (EUS-CDS), are alternative methods for biliary drainage in patients with distal malignant biliary obstruction (MBO) after failed endoscopic retrograde cholangiopancreatography (ERCP). Data on long-term outcomes, adverse events (AEs), and quality of life (QoL) after EUS-CDS and PTBD are limited. Therefore, we created a registry to evaluate the outcomes of both drainage procedures. Methods:Patients with distal MBO who underwent EUS CDS or PTBD after unsuccessful ERCP were included in this multicenter investigator-initiated prospective registry over an 18-month inclusion period. Primary end points were procedure-related AEs and mortality within 90 days post procedure. Secondary end points included technical and clinical success, reinterventions, hospital stay, and QoL. Results:55patients wereincluded, with 12patients under going PTBD (technical success 100%) and 43 patients EUS CDS (technical success 97.7%). Prior to ERCP, 7/12 patients in the PTBDgroupand12/43patientsintheEUS-CDSgroup opted for best supportive care. The 90-day mortality rate was 66.7% in the PTBD group and 20.9% in the EUS-CDS group (P=0.005). Furthermore, 11/12 patients (91.7%) in the PTBD group and 19/43 (44.2%) in the EUS-CDS group developed one or more AEs (P=0.004). The median post procedural hospital stay was 4 days (interquartile range [IQR] 2-6) in the PTBD group vs. 1 day (IQR 1-2) in the EUS-CDS group (P=0.001). Conclusion:When both modalities were available and technically feasible, gastroenterologists preferred EUS-CDS over PTBD. EUS-CDS seems to be associated with lower mortality and AErates, shorter hospital admission, and few er reinterventions, but a randomized controlled trial should confirm these observations.

UR - https://www.scopus.com/pages/publications/105006497044

U2 - 10.1055/a-2580-1316

DO - 10.1055/a-2580-1316

M3 - Article

C2 - 40209763

AN - SCOPUS:105006497044

SN - 0013-726X

VL - 57

SP - 1004

EP - 1015

JO - Endoscopy

JF - Endoscopy

IS - 9

ER -

Endoscopic ultrasound-guided choledochoduodenostomy results in fewer complications than percutaneous drainage following failed ERCP in malignant distal biliary obstruction

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