Open AccessRisk Factors for Stent Migration into the Abdominal Cavity after Endoscopic Ultrasound-Guided Hepaticogastrostomy
Author(s) -
Kazushige Ochiai,
Toshio Fujisawa,
Shōzō Ishii,
Akira Suzuki,
Hiroaki Saito,
Yusuke Takasaki,
Mako Ushio,
Sho Takahashi,
Wataru Yamagata,
Ko Tomishima,
Tadakazu Hisamatsu,
Hiroyuki Isayama
Publication year - 2021
Publication title -
journal of clinical medicine
Language(s) - English
Resource type - Journals
ISSN - 2077-0383
DOI - 10.3390/jcm10143111
Subject(s) - medicine , stent , endoscopic ultrasound , abdominal cavity , radiology , stomach , surgery
Background: Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is becoming increasingly popular. However, the risk factors for stent migration into the abdominal cavity remain unknown. Methods: Forty-eight patients undergoing EUS-HGS with placement of a long, partially covered self-expandable metallic stent (LPC-SEMS) were studied retrospectively to identify risk factors of stent migration. We determined the technical and functional success rates, and recorded adverse events, including stent migration. Results: EUS-HGS was technically successful in all patients. However, stent migration was evident in five patients (one actual and four imminent, 10%). Stent migration into the abdominal cavity was observed in one patient (2%), and the other four cases required additional procedures to prevent migration (8%). Logistic regression analysis revealed that the risk of stent migration increased as the initial (pre-procedure) distance between the stomach and liver at the puncture site increased ( p = 0.012). Conclusions: A longer distance between the stomach and liver at the puncture site increased the risk of stent migration. However, during EUS-HGS, it is difficult to adjust the puncture position. It is important to ensure that the proportion of the stent in the stomach is large; the use of a self-anchoring stent may be optimal.