Premium
Novel method of endoscopic ultrasound‐guided hepaticogastrostomy to prevent stent dysfunction
Author(s) -
Ogura Takeshi,
Kurisu Yoshitaka,
Masuda Daisuke,
Imoto Akira,
Hayashi Michihiro,
Malak Mohamed,
Umegaki Eiji,
Uchiyama Kazuhisa,
Higuchi Kazuhide
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12598
Subject(s) - medicine , endoscopic ultrasound , stent , major duodenal papilla , radiology , surgery , biliary drainage , endoscopy
Background and Study Aim The present study assesses the feasibility as well as the technical and functional success rates of a novel endoscopic ultrasound‐guided hepaticogastrostomy ( EUS‐HGS ) technique called the locking stent method that uses end‐bare covered metallic stents ( EBCMS ). Methods Twenty consecutive patients who were histologically diagnosed with unresectable cancer complicated with obstructive jaundice underwent EUS‐HGS due to failed endoscopic biliary drainage or inaccessible papilla. We retrospectively collected clinical data for these patients including technical and functional success rates and complications. Results Seven were treated by EUS‐HGS ( EUS‐HGS group), and 13 were treated using the locking stent EUS‐HGS method ( LS group). Technical and functional success rates were 100% in both groups. Procedural duration did not significantly differ between the EUS‐HGS and LS groups (26.9 ± 9.0 versus 32.3 ± 11.1 min, P = 0.30). Two patients developed complications related to stent migration in the EUS‐HGS group. In contrast, although mild post‐procedural bile peritonitis required conservative treatment for a few days, none of the stents malfunctioned in the LS group. Conclusion Our method can safely and effectively prevent stent dysfunction, but validation in a prospective clinical trial is required.