OR-THER-04: Long-term outcomes and reintervention of endoscopic ultrasound-guided biliary drainage for malignant biliary obstruction: A multicenter retrospective analysis of 96 cases

S8 ENDOSCOPIC ULTRASOUND / VOLUME 6 / SUPPLEMENT 1 / AUGUST 2017 treated by EUS-CYA. Patients were followed up for 6 months after EUS or till death. A historical control group of HCC patients who underwent esophagogastroduodenoscopy-CYA (EGD-CYA) for index gastroesophageal variceal bleeding alone was identified in a prospective gastrointestinal bleed database from 2009 to 2013 for comparison. Results: Twentythree patients underwent EUS-CYA for SP, while 33 HCC patients who underwent EGD-CYA for index variceal bleeding alone were identified as historical controls. In the EUS-CYA group, twenty patients had HCC + cirrhosis (85.0% also with PVT), while the other three patients had non-HCC malignancy + PVT. Majority of the HCC patients in both groups had Barcelona clinic liver cancer Stage C disease (85.0% vs. 75.8%, P = 0.421) and Child-Pugh Class B cirrhosis (55.0% vs. 71.4%, P = 0.241). Both the 30and 90-day death adjusted cumulative incidence of rebleeding was significantly lower in the EUS-CYA group when compared to EGD-CYA control group (13% vs. 42% at 30-day, P = 0.023 and 22% vs. 61% at 90-day, P = 0.005, respectively). Conclusion: EUS-CYA for SP significantly reduces both the 30-day and 90-day death adjusted cumulative incidence of rebleeding in patients at high risk for recurrent gastroesophageal variceal bleeding when compared to EGD-CYA for index bleeding alone. DOI: 10.4103/2303-9027.212265