Endoscopy 2022; 54(S 01): S28-S29
DOI: 10.1055/s-0042-1744615
Abstracts | ESGE Days 2022
ESGE Days 2022 Oral presentations
13:30-14:30 Thursday, 28 April 2022 Club H. Accessing the gallbladder and bile duct

EFFICACY AND SAFETY OF ENDOSCOPIC ULTRASOUND-GUIDED HEPATICO-GASTROSTOMY: A META-REGRESSION ANALYSIS

C. Binda
1   AUSL Romagna, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, Forlì-Cesena, Italy
,
E. Dajti
1   AUSL Romagna, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, Forlì-Cesena, Italy
2   Alma Mater Studiorum – University of Bologna, Department of Medical and Surgical Sciences-DIMEC, Bologna, Italy
,
A. Cucchetti
2   Alma Mater Studiorum – University of Bologna, Department of Medical and Surgical Sciences-DIMEC, Bologna, Italy
3   AUSL Romagna, Morgagni-Pierantoni Hospital, Forlì, Italy
,
C. Coluccio
1   AUSL Romagna, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, Forlì-Cesena, Italy
,
A. Repici
4   Humanitas Clinical and Research Center-IRCCS, Division of Gastroenterology, Digestive Endoscopy Unit, Rozzano, Italy
5   Humanitas University, Department of Biomedical Sciences, Milano, Italy
,
A. Anderloni
4   Humanitas Clinical and Research Center-IRCCS, Division of Gastroenterology, Digestive Endoscopy Unit, Rozzano, Italy
,
G. Ercolani
2   Alma Mater Studiorum – University of Bologna, Department of Medical and Surgical Sciences-DIMEC, Bologna, Italy
3   AUSL Romagna, Morgagni-Pierantoni Hospital, Forlì, Italy
,
C. Fabbri
1   AUSL Romagna, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, Forlì-Cesena, Italy
› Author Affiliations
› Further Information
Also available at
 

Aims EUS-guided hepaticogastrostomy (EUS-HGS) is valid option of EUS-guided biliary drainage that has been increasingly used in the last ten years. Aims of the study were to provide a systematic review with meta-analysis and meta-regression of features and outcomes after this procedure.

Methods MEDLINE, Scopus, Web-of-Science, and Cochrane databases were searched for literature pertinent to EUS-HHS. Meta-analysis of proportions and meta-regression of potential modifiers of the main outcome measures were applied. Main outcome measures were technical success rate, intention-to-treat (ITT) clinical success and procedure-related adverse events (AEs).

Results Thirty-eight studies including 1335 patients enrolled were included in the meta-analysis. Malignant biliary obstruction was the underlying cause in almost all (99.6%) cases; the main indications for EUS-HGS were duodenal/papillary invasion (32.6%), surgical altered anatomy (19.4%), and hilar stenosis (19.3%). Pooled technical success of EUS-HGS was 96.8% (95%C.I.: 95, 97.9, heterogeneity: 0%), the ITT clinical success was 88.3% (95%C.I.: 84.9, 90.9; heterogeneity: 24.9%) and procedure-related AEs occurred in 11.6% (95%C.I.: 10, 13.4; heterogeneity: 0%), being cholangitis/sepsis (3%) and bleeding (2.1%) the most frequent. Meta-regression showed that technical success rate was modified by centers’ experience (>4/year), rate of patients with duodenal invasion. No modifiers of ITT clinical success were identified. The rate of procedure-related AEs was reduced with increasing publication year and the use of dedicated stents.

Conclusions EUS-HGS represents an efficient and safe route for EUS-guided biliary drainage in patients with malignant biliary obstruction. Future studies should address the impact of center experience, patient selection and use of dedicated stents to improve this technique’s performance.



Publication History

Article published online:
14 April 2022

© 2022. European Society of Gastrointestinal Endoscopy. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany