Technical Feasibility and Safety of One-step Deployment of EUS-guided Hepaticogastrostomy Using an 8-mm Diameter Metal Stent with a Fine-gauge Stent Delivery System (with Video)

Overview

Journal Endosc Ultrasound

Date 2021 Aug 24

PMID 34427190

Citations 12

Authors

Takeshi Ogura

Saori Ueno

Atsushi Okuda

Nobu Nishioka

Masanori Yamada

Jun Matsuno

Kazuya Ueshima

Yoshitaro Yamamoto

Kazuhide Higuchi

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: Adverse events (AEs) such as bile peritonitis or pneumoperitoneum might occur during procedural steps for EUS-guided hepaticogastrostomy (HGS), such as during device exchange and after fistula dilation until stent deployment. Reducing the steps to the EUS-HGS procedure might therefore be ideal to prevent the occurrence of AEs. Recently, a novel, fully covered self-expandable metal stent (FCSEMS) has become available. Because of the fine-gauge stent delivery system (5.9Fr), fistula dilation might not be needed before stent deployment during EUS-HGS. The aim of this pilot study was to evaluate the technical feasibility and safety of one-step EUS-HGS using a novel 8-mm diameter FCSEMS.

Patients And Methods: The primary outcome in this study was technical success, and the secondary outcomes were procedure- and stent-related AEs and clinical success. The technical success of one-step EUS-HGS was defined as successful FCSEMS deployment without any fistula dilation. Procedure time was measured from scope insertion to successful FCSEMS deployment.

Results: One-step EUS-HGS using the novel FCSEMS was attempted on 14 patients. Technical success with a short procedure time (median: 7 min) and clinical success were obtained in all patients. In addition, procedure-related AEs such as bleeding, bile peritonitis, and stent migration during the procedure were not observed in any patients.

Conclusions: One-step EUS-HGS using the novel FCSEMS with a fine-gauge stent delivery system is technically feasible and shortens the procedure time with no requirement for additional fistula dilation, resulting in a potential reduction in procedure-related AEs.

Citing Articles

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