Usefulness of the laser-cut, fully covered, self-expandable metallic stent for endoscopic ultrasound-guided hepaticogastrostomy
Shota Harai
Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Japan, Chuo-ku, Japan
First Department of Internal medicine, Faculty of Medicine Graduate School of Medicine, University of Yamanashi, Chuo-shi, Japan
Search for more papers by this authorCorresponding Author
Susumu Hijioka
Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Japan, Chuo-ku, Japan
Correspondence
Susumu Hijioka, National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
Email: [email protected]
Search for more papers by this authorYoshikuni Nagashio
Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Japan, Chuo-ku, Japan
Search for more papers by this authorAkihiro Ohba
Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Japan, Chuo-ku, Japan
Search for more papers by this authorYuta Maruki
Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Japan, Chuo-ku, Japan
Search for more papers by this authorMiyuki Sone
Department of Diagnostic Radiology, National Cancer Center Japan, Chuo-ku, Japan
Search for more papers by this authorYutaka Saito
Department of Endoscopy, National Cancer Center Japan, Chuo-ku, Japan
Search for more papers by this authorTakuji Okusaka
Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Japan, Chuo-ku, Japan
Search for more papers by this authorMitsuharu Fukasawa
First Department of Internal medicine, Faculty of Medicine Graduate School of Medicine, University of Yamanashi, Chuo-shi, Japan
Search for more papers by this authorNobuyuki Enomoto
First Department of Internal medicine, Faculty of Medicine Graduate School of Medicine, University of Yamanashi, Chuo-shi, Japan
Search for more papers by this authorShota Harai
Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Japan, Chuo-ku, Japan
First Department of Internal medicine, Faculty of Medicine Graduate School of Medicine, University of Yamanashi, Chuo-shi, Japan
Search for more papers by this authorCorresponding Author
Susumu Hijioka
Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Japan, Chuo-ku, Japan
Correspondence
Susumu Hijioka, National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
Email: [email protected]
Search for more papers by this authorYoshikuni Nagashio
Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Japan, Chuo-ku, Japan
Search for more papers by this authorAkihiro Ohba
Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Japan, Chuo-ku, Japan
Search for more papers by this authorYuta Maruki
Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Japan, Chuo-ku, Japan
Search for more papers by this authorMiyuki Sone
Department of Diagnostic Radiology, National Cancer Center Japan, Chuo-ku, Japan
Search for more papers by this authorYutaka Saito
Department of Endoscopy, National Cancer Center Japan, Chuo-ku, Japan
Search for more papers by this authorTakuji Okusaka
Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Japan, Chuo-ku, Japan
Search for more papers by this authorMitsuharu Fukasawa
First Department of Internal medicine, Faculty of Medicine Graduate School of Medicine, University of Yamanashi, Chuo-shi, Japan
Search for more papers by this authorNobuyuki Enomoto
First Department of Internal medicine, Faculty of Medicine Graduate School of Medicine, University of Yamanashi, Chuo-shi, Japan
Search for more papers by this authorAbstract
Background/Purpose
Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) has many associated adverse events. We evaluated the clinical efficacy and safety of the laser-cut, fully covered, self-expandable metallic stent (FCSEMS) for this procedure.
Methods
This single-center, retrospective study included cases where EUS-HGS with a laser-cut FCSEMS was performed for malignant biliary obstruction. Technical and clinical success, time to recurrent biliary obstruction (TRBO), procedure time, adverse events, and re-interventions were evaluated.
Results
There were 95 eligible cases. Technical and clinical success rates were 100.0% and 95.8%, respectively. Median TRBO was 398 days. RBO causes were hyperplasia (7.4%), debris (3.2%), and migration (4.2%). Adverse events occurred in nine cases (9.5%). Non-occlusion and focal cholangitis occurred in four cases (4.2%) each. Nineteen patients (20%) underwent combined EUS-HGS (CH) procedures: antegrade stenting, bridging methods, plastic stent anchoring in SEMS, and EUS-hepaticoduodenostomy. The solely EUS-HGS (SH) group had significantly longer median TRBO than the CH group (398 vs 246 days, P = .04). There were no significant differences in adverse events between the two groups. Re-intervention was performed in 29 cases (technical success rate: 100.0%).
Conclusions
Laser-cut FCSEMS can be safely placed in the bile duct and easily applied during re-intervention, making it useful in EUS-HGS.
CONFLICT OF INTEREST
The authors declare no conflicts of interest.
Supporting Information
| Filename | Description |
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| JHBP1165-sup-0001-FigureS1.jpgimage/jpp, 457.5 KB |
Figure S1 |
| JHBP1165-sup-0002-FigureS2.jpgimage/jpp, 474.3 KB |
Figure S2 |
| JHBP1165-sup-0003-TableS1-S3.docxWord 2007 document , 25.6 KB |
Table S1 |
| JHBP1165-sup-0004-VideoS1.mp4MPEG-4 video, 113 MB |
Video S1 |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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