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Open Access
CC BY 4.0 · Journal of Clinical Interventional Radiology ISVIR
DOI: 10.1055/s-0045-1813214
Case Series

Percutaneous Hepaticogastrostomy for Failed Endoscopic Drainage

Authors

  • Shubham Suryavanshi

    1   Division of Hepatobiliary Interventional Radiology, Center of Excellence in GI Sciences, Rajagiri Hospital, Kochi, Kerala, India

  • Akhil Baby

    1   Division of Hepatobiliary Interventional Radiology, Center of Excellence in GI Sciences, Rajagiri Hospital, Kochi, Kerala, India

  • Dibyamohan Hazarika

    2   Interventional Radiology Department, Nemcare Super specialty Hospital, Guwahati, Assam

  • Somsharan Betgeri

    3   Interventional Radiology Department, Caritas Hospital, Kottayam, Kerala

  • Rajesh Sasidharan 

    1   Division of Hepatobiliary Interventional Radiology, Center of Excellence in GI Sciences, Rajagiri Hospital, Kochi, Kerala, India
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Abstract

Hepaticogastrostomy (HGS) serves as an alternative approach for biliary drainage in patients with difficult-to-cross perihilar biliary strictures. Although endoscopic ultrasound-guided HGS (EUS-HGS) has become widely accepted, it can sometimes fail due to technical challenges with duct access and guidewire manipulation. In such situations, percutaneous HGS (P-HGS) offers a valuable alternative. We report our experience with three patients treated with P-HGS between February 2020 and July 2023. Conventional percutaneous and endoscopic methods as well as EUS-HGS had failed to internalize the drainage catheter in all the cases. Technical success was achieved in all the three cases. Self-limiting bile leak was seen in one patient. Rest of the patients did not develop any major complications. After a mean follow-up of 10.3 months (range, 5–14 months), P-HGS stents were patent in all three patients. In conclusion, P-HGS is technically feasible and an effective alternative to EUS-HGS or long-term external biliary drainage for noninternalizable malignant biliary strictures.

Keywords

hepaticogastrostomy - endoscopic ultrasound - cholangiocarcinoma


Publication History

Article published online:
21 November 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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