A retrospective study comparing EUS-BD and ERCP-BD after duodenal stent placement in patients with malignant biliary and duodenal obstruction

In patients with malignant biliary and duodenal obstruction (MBDO), biliary and duodenal double stenting is necessary. However, whether the time to recurrent biliary obstruction (TRBO) can be extended with ERCP-guided biliary drainage (ERCP-BD) or EUS-guided BD (EUS-BD) has not been sufficiently elucidated. Therefore, the aim of this study was to determine whether ERCP-BD or EUS-BD was more useful for increasing the TRBO with duodenal stenting. We compared the TRBO with duodenal stenting and other clinical outcomes between ERCP-BD and EUS-BD in MBDO patients. We matched the patient characteristics of the two groups using propensity scores. Technical success was greater in the EUS-BD group (n = 17/17, 100%) than in the ERCP-BD group (n = 32/52, 61.5%) (p < 0.01). After propensity score matching, 17 matched pairs were included for further analysis. There was no significant difference in the TRBO following duodenal stenting between the ERCP-BD group (median of 62 days) and the EUS-BD group (median of 68 days) (p = 0.94). The TRBO following duodenal stenting was comparable between ERCP-BD and EUS-BD. The technical success of EUS-BD was superior to that of ERCP-BD; therefore, EUS-BD might be the optimal choice for endoscopic BD in MBDO patients.