Su1362 Single-Step Enhanced-Cautery Vs Multi-Step Eus Guided Gallbladder and Bile Duct Drainage Using a Lumen-Apposing Metal Stent (Lams)

Creation of an EUS-guided cholecysto-enterostomy (EUS-CE) and choledocho-enterostomy (EUS-CDE) using a LAMS has been reported in several series for the palliative management of symptomatic biliary tract obstruction. LAMS drainage has required a multi-step approach (MSA) until the recent availability of a cautery-enhanced delivery system that enables a single-step approach (SSA), eliminating guidewire placement and over-the-guidewire catheter exchanges. We hypothesized that SSA can be performed more quickly than MSA, without the need for fluoroscopy, with equivalent technical / clinical success and adverse event rates.