Endoscopy 2024; 56(11): 864-869
DOI: 10.1055/a-2340-7432
Innovations and brief communications

Dedicated cautery-enhanced tubular self-expandable metal stent for endoscopic ultrasound-guided hepaticogastrostomy: feasibility study

1   Gastroenterology, Hospital San Juan de Dios, Caja Costarricense de Seguro Social, San Jose, Costa Rica
,
2   Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, Hong Kong
,
Jahnvi Dhar
3   Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India (Ringgold ID: RIN29751)
,
2   Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, Hong Kong
,
4   Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
5   Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
,
Marc Giovannini
6   Gastroenterology, Institut Paoli-Calmettes, Marseille, France (Ringgold ID: RIN56181)
› Author Affiliations


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



Publication History

Received: 27 March 2024

Accepted after revision: 07 June 2024

Accepted Manuscript online:
07 June 2024

Article published online:
04 July 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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