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DOI: 10.1055/a-2340-7432
Dedicated cautery-enhanced tubular self-expandable metal stent for endoscopic ultrasound-guided hepaticogastrostomy: feasibility study
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Abstract
Background Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is an alternative for biliary drainage in patients with obstructive pancreaticobiliary pathology when endoscopic retrograde cholangiopancreatography (ERCP) is not feasible. Despite its effectiveness, EUS-HGS is associated with a significant risk of adverse events. This study aimed to evaluate the feasibility and safety of a newly designed dedicated cautery-enhanced tubular self-expandable metal stent (SEMS) for EUS-HGS.
Methods This multicenter prospective study included patients with malignant biliary obstruction in whom ERCP had failed because of tumor infiltration, inability to drain the intrahepatic ducts, or surgically altered anatomy. A dedicated cautery-enhanced tubular SEMS was used for EUS-HGS. Technical and clinical success rates, procedure times, and adverse events were evaluated.
Results 20 patients underwent EUS-HGS with the dedicated stent. Technical and clinical success rates of 100% were achieved, with no reported severe adverse events or mortality. The median procedure time was 16 minutes. Recurrent biliary obstruction was observed in 1 patient.
Conclusions The dedicated cautery-enhanced tubular SEMS for EUS-HGS can simplify the procedure and enhance its safety and efficacy. This innovation shows promise for improving patient outcomes, although further studies are needed to validate these findings in a broader patient population.
Graphical Abstract
Publikationsverlauf
Eingereicht: 27. März 2024
Angenommen nach Revision: 07. Juni 2024
Accepted Manuscript online:
07. Juni 2024
Artikel online veröffentlicht:
04. Juli 2024
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References
- 1 Ogura T, Higuchi K. Technical tips for endoscopic ultrasound-guided hepaticogastrostomy. World J Gastroenterol 2016; 22: 3945-3951 DOI: 10.5009/gnl20096. (PMID: 32694240)
- 2 Yamazaki H, Yamashita Y, Shimokawa T. et al. Endoscopic ultrasound‐guided hepaticogastrostomy versus choledochoduodenostomy for malignant biliary obstruction: A meta‐analysis. DEN Open 2024; 4: e274 DOI: 10.1002/deo2.274. (PMID: 37455944)
- 3 Miyano A, Ogura T, Yamamoto K. et al. Clinical impact of the intra-scope channel stent release technique in preventing stent migration during EUS-guided hepaticogastrostomy. J Gastrointest Surg 2018; 22: 1312-1318
- 4 Nass KJ, Zwager LW, van der Vlugt M. et al. Novel classification for adverse events in GI endoscopy: the AGREE classification. Gastrointest Endosc 2022; 95: 1078-1085.e8
- 5 Khashab MA, Messallam AA, Penas I. et al. International multicenter comparative trial of transluminal EUS-guided biliary drainage via hepatogastrostomy vs. choledochoduodenostomy approaches. Endosc Int Open 2016; 04: E175-181 DOI: 10.1055/s-0041-109083. (PMID: 26878045)
- 6 Park DH, Jang JW, Lee SS. et al. EUS-guided biliary drainage with transluminal stenting after failed ERCP: predictors of adverse events and long-term results. Gastrointest Endosc 2011; 74: 1276-1284
- 7 Honjo M, Itoi T, Tsuchiya T. et al. Safety and efficacy of ultra-tapered mechanical dilator for EUS-guided hepaticogastrostomy and pancreatic duct drainage compared with electrocautery dilator (with video). Endosc Ultrasound 2018; 7: 376-382
- 8 Amano M, Ogura T, Onda S. et al. Prospective clinical study of endoscopic ultrasound‐guided biliary drainage using novel balloon catheter (with video). J Gastroenterol Hepatol 2017; 32: 716-720
- 9 Nakai Y, Sato T, Hakuta R. et al. Long-term outcomes of a long, partially covered metal stent for EUS-guided hepaticogastrostomy in patients with malignant biliary obstruction (with video). Gastrointest Endosc 2020; 92: 623-631.e1