ELEMENT trial - EUS-CDS and ERCP RCT in stage-3/4 extrahepatic BD obstruction

 







  • 70 patients randomized to each EUS-CDS (6x8 mm axios) and ERCP arm
  • EUS-CDS was quicker (14 mins vs 24 mins), had similar technical and clinical success
  • Same rate of early adverse events, and delayed stent obstruction
  • 5-8% underwent Whipples - no increased difficulty with whipple in EUS-CDS arm (similar surgical duration, similar adverse event, similar post-op hospitalization duration) when compared to ERCP
  • Zero risk of pancreatitis - as expected.

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