Safety and effectiveness of a long, partially covered metal stent for endoscopic ultrasound-guided hepaticogastrostomy in patients with malignant biliary obstruction.

Abstract:

:Background and study aims: Endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) is potentially complicated by bile leak and stent migration. The aim of this study was to evaluate the safety and effectiveness of a long (≥ 10 cm), partially covered metal stent (LP-CMS) for EUS-guided hepaticogastrostomy (EUS-HGS) for malignant biliary obstruction. Both the stent length and the uncovered portion at the proximal end of the LP-CMS are designed to prevent stent migration. Patients and methods: A total of 33 patients undergoing EUS-HGS using an LP-CMS in four centers were retrospectively studied. Technical and clinical success, adverse events, and recurrent biliary obstruction were evaluated. Results: Gastric outlet obstruction (76 %) and surgically altered anatomy (15 %) were two major reasons for EUS-HGS. The technical and clinical success rates were 100 %. The median intragastric stent length was 54 mm. The adverse event rate was 9 %. No stent migration was observed. Recurrent biliary obstruction developed in 24 %, with a median cumulative time to recurrence of 8.5 months. Conclusions: EUS-HGS using an LP-CMS for unresectable malignant biliary obstruction was safe and effective.

journal_name

Endoscopy

journal_title

Endoscopy

authors

Nakai Y,Isayama H,Yamamoto N,Matsubara S,Ito Y,Sasahira N,Hakuta R,Umefune G,Takahara N,Hamada T,Mizuno S,Kogure H,Tada M,Koike K

doi

10.1055/s-0042-116595

subject

Has Abstract

pub_date

2016-12-01 00:00:00

pages

1125-1128

issue

12

eissn

0013-726X

issn

1438-8812

journal_volume

48

pub_type

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