May 6, 2015

A newly designed plastic stent for EUS-guided hepaticogastrostomy: a prospective preliminary feasibility study (with videos)

Gastrointestinal Endoscopy
Junko UmedaFuminori Moriyasu

Abstract

There are currently no dedicated plastic stents for EUS-guided hepaticogastrostomy (EUS-HGS). We prospectively evaluated the feasibility and the technical and functional success rates of our newly designed plastic stent for EUS-HGS. Prospective preliminary feasibility study. A tertiary-care referral center. Twenty-three consecutive patients were treated. The reasons for requiring EUS-HGS were periampullary tumor invasion (n=9), altered anatomy (n=7), failed duodenal intubation (n=3), and previous ERCP failure (n=4). An 8F single-pigtail plastic stent with 4 flanges was placed for EUS-HGS. Technical success, clinical success, and adverse events according to the American Society for Gastrointestinal Endoscopy lexicon. All stents were successfully deployed without procedural adverse events (100% technical success rate). Bleeding from the punctured gastric wall occurred in 1 patient 3 days postoperatively. We exchanged the plastic stent for a fully covered self-expandable metal stent. A mild adverse event of self-limited abdominal pain occurred in 3 patients. Treatment success was achieved in all patients. The occlusion rate was 13.7% (3/22) during the median follow-up period (5.0 months, range 0.5-12.5 months). The median duration...Continue Reading

Mentioned in this Paper

Endoscopy, Gastrointestinal
Endoscopy (Procedure)
Follow-up
Dislocations
Anatomic Structures
Abdominal Pain
Tertiary Care Centers
Stent, Device
Neoplasms
Incidence Studies

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