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Notes:
Volume 7, Issue 6 (Suppl)
J Gastrointest Dig Syst, an open access journal
ISSN: 2161-069X
Page 32
December 07-08, 2017 Madrid, Spain
&
13
th
International Conference on Clinical Gastroenterology & Hepatology
2
nd
International Conference on Digestive Diseases
CO-ORGANIZED EVENT
Therapeutic interventional endoscopic ultrasound in advanced biliary malignancy
C Rinaldi A Lesmana
Medistra Hospital, Indonesia
B
iliary malignancy is one of the challenging problem in the field of gastroenterology. It requires multi-disciplinary and
multi-modalities approach to give a better patient’s management. However, clinical expertise in the new era of advance
diagnostic imaging and also innovation in therapeutic modalities become more debatable regarding the human resources,
hospital investment and cost, and also the patients’ expenditure with future outcome of the disease itself. The most therapeutic
modality which has been used widely in advance stage of biliary malignancy case is known as endoscopic retrograde
cholangiopancreatography (ERCP) procedure, however the patient’s survival rate has become the most important thing before
deciding the most appropriate procedure. The risk and possible complications during and after ERCP procedure, such as
bleeding, pancreatitis, perforation also need to be considered and put together in clinical practice. Another option such as
percutaneous trans hepatic biliary drainage (PTBD) has been considered when ERCP is unsuccessful and due to the simple
steps of PTBD, it might become the first of choice when the patient’s condition is contraindicated for advance procedure or deep
sedation. Endoscopic ultrasound (EUS) is an old time innovation with new regeneration in the field of therapeutic endoscopic
procedures. Recently, its development has giving many promising interventional procedures in Hepatopancreatobiliary
diseases. The role of EUS biliary drainage (EUS-BD) is one of the cutting-edge that has been used in biliary obstruction due
to advance biliary malignancy. It combines ERCP and interventional trans abdominal ultrasound techniques to approach
and managing bile duct obstruction. It also requires dedicated accessories to make the procedure successful. Therapeutic
interventional EUS has been considered as a new cutting-edge innovation for managing advance biliary malignant cases,
however the cost benefit of this procedure should be always considered in most of patients with advanced biliary malignancy
with biliary obstruction.
Biography
Cosmas Rinaldi A. Lesmana is Senior Lecturer at Department of Internal Medicine, Hepatobiliary Division, Cipto Mangunkusumo Hospital, University of Indonesia
and Consultant Gastroenterologist & Hepatologist at Cipto Mangunkusumo Hospital.
medicaldr2001id@yahoo.comC Rinaldi A Lesmana, J Gastrointest Dig Syst 2017, 7:6(Suppl)
DOI: 10.4172/2161-069X-C1-058