Endoscopic ultrasound-guided hepaticogastrostomy and endoscopic retrograde cholangiopancreatography-guided biliary drainage for distal malignant biliary obstruction due to pancreatic cancer with asymptomatic duodenal invasion: a retrospective, single-center study in Japan
Background/Aims Duodenal invasion (DI) is a risk factor for early recurrent biliary obstruction (RBO) in endoscopic retrograde cholangiopancreatography-guided biliary drainage (ERCP-BD). Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) may reduce early RBO in cases of asymptomatic DI, even...
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Korean Society of Gastrointestinal Endoscopy
2025-01-01
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| Series: | Clinical Endoscopy |
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| Online Access: | http://www.e-ce.org/upload/pdf/ce-2024-031.pdf |
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| author | Naminatsu Takahara Yousuke Nakai Kensaku Noguchi Tatsunori Suzuki Tatsuya Sato Ryunosuke Hakuta Kazunaga Ishigaki Tomotaka Saito Tsuyoshi Hamada Mitsuhiro Fujishiro |
| author_facet | Naminatsu Takahara Yousuke Nakai Kensaku Noguchi Tatsunori Suzuki Tatsuya Sato Ryunosuke Hakuta Kazunaga Ishigaki Tomotaka Saito Tsuyoshi Hamada Mitsuhiro Fujishiro |
| author_sort | Naminatsu Takahara |
| collection | DOAJ |
| description | Background/Aims Duodenal invasion (DI) is a risk factor for early recurrent biliary obstruction (RBO) in endoscopic retrograde cholangiopancreatography-guided biliary drainage (ERCP-BD). Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) may reduce early RBO in cases of asymptomatic DI, even when ERCP is possible. Methods We enrolled 56 patients with pancreatic cancer and asymptomatic DI who underwent EUS-HGS (n=25) or ERCP-BD (n=31). Technical and clinical success, early (<3 months) and overall RBO rates, time to RBO (TRBO), and adverse events were compared between the EUS-HGS and ERCP-BD groups. Risk factors for early RBO were also evaluated. Results Baseline characteristics were similar between the groups. Both procedures demonstrated 100% technical and clinical success rates, with a similar incidence of adverse events (48% vs. 39%, p=0.59). While the median TRBO was comparable (5.7 vs. 8.8 months, p=0.60), EUS-HGS was associated with a lower incidence of early RBO compared to ERCP-BD (8% vs. 29%, p=0.09). The major causes of early RBO in ERCP-BD were sludge and food impaction, rarely occurring in EUS-HGS. EUS-HGS was potentially reduced early RBO (odds ratio, 0.32; p=0.07). Conclusions EUS-HGS can be a viable option for treating pancreatic cancer with asymptomatic DI. |
| format | Article |
| id | doaj-art-a8a65c98ee3845cdb0b922aab32ce93a |
| institution | Kabale University |
| issn | 2234-2400 2234-2443 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj-art-a8a65c98ee3845cdb0b922aab32ce93a2025-02-03T08:08:03ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432025-01-0158113414310.5946/ce.2024.0317910Endoscopic ultrasound-guided hepaticogastrostomy and endoscopic retrograde cholangiopancreatography-guided biliary drainage for distal malignant biliary obstruction due to pancreatic cancer with asymptomatic duodenal invasion: a retrospective, single-center study in JapanNaminatsu Takahara0Yousuke Nakai1Kensaku Noguchi2Tatsunori Suzuki3Tatsuya Sato4Ryunosuke Hakuta5Kazunaga Ishigaki6Tomotaka Saito7Tsuyoshi Hamada8Mitsuhiro Fujishiro9 Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of Chemotherapy, The University of Tokyo Hospital, Tokyo, Japan Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanBackground/Aims Duodenal invasion (DI) is a risk factor for early recurrent biliary obstruction (RBO) in endoscopic retrograde cholangiopancreatography-guided biliary drainage (ERCP-BD). Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) may reduce early RBO in cases of asymptomatic DI, even when ERCP is possible. Methods We enrolled 56 patients with pancreatic cancer and asymptomatic DI who underwent EUS-HGS (n=25) or ERCP-BD (n=31). Technical and clinical success, early (<3 months) and overall RBO rates, time to RBO (TRBO), and adverse events were compared between the EUS-HGS and ERCP-BD groups. Risk factors for early RBO were also evaluated. Results Baseline characteristics were similar between the groups. Both procedures demonstrated 100% technical and clinical success rates, with a similar incidence of adverse events (48% vs. 39%, p=0.59). While the median TRBO was comparable (5.7 vs. 8.8 months, p=0.60), EUS-HGS was associated with a lower incidence of early RBO compared to ERCP-BD (8% vs. 29%, p=0.09). The major causes of early RBO in ERCP-BD were sludge and food impaction, rarely occurring in EUS-HGS. EUS-HGS was potentially reduced early RBO (odds ratio, 0.32; p=0.07). Conclusions EUS-HGS can be a viable option for treating pancreatic cancer with asymptomatic DI.http://www.e-ce.org/upload/pdf/ce-2024-031.pdfduodenal invasionendoscopic retrograde cholangiopancreatographyendoscopic ultrasound-guided hepaticogastrostomymalignant biliary obstructionpancreatic cancer |
| spellingShingle | Naminatsu Takahara Yousuke Nakai Kensaku Noguchi Tatsunori Suzuki Tatsuya Sato Ryunosuke Hakuta Kazunaga Ishigaki Tomotaka Saito Tsuyoshi Hamada Mitsuhiro Fujishiro Endoscopic ultrasound-guided hepaticogastrostomy and endoscopic retrograde cholangiopancreatography-guided biliary drainage for distal malignant biliary obstruction due to pancreatic cancer with asymptomatic duodenal invasion: a retrospective, single-center study in Japan Clinical Endoscopy duodenal invasion endoscopic retrograde cholangiopancreatography endoscopic ultrasound-guided hepaticogastrostomy malignant biliary obstruction pancreatic cancer |
| title | Endoscopic ultrasound-guided hepaticogastrostomy and endoscopic retrograde cholangiopancreatography-guided biliary drainage for distal malignant biliary obstruction due to pancreatic cancer with asymptomatic duodenal invasion: a retrospective, single-center study in Japan |
| title_full | Endoscopic ultrasound-guided hepaticogastrostomy and endoscopic retrograde cholangiopancreatography-guided biliary drainage for distal malignant biliary obstruction due to pancreatic cancer with asymptomatic duodenal invasion: a retrospective, single-center study in Japan |
| title_fullStr | Endoscopic ultrasound-guided hepaticogastrostomy and endoscopic retrograde cholangiopancreatography-guided biliary drainage for distal malignant biliary obstruction due to pancreatic cancer with asymptomatic duodenal invasion: a retrospective, single-center study in Japan |
| title_full_unstemmed | Endoscopic ultrasound-guided hepaticogastrostomy and endoscopic retrograde cholangiopancreatography-guided biliary drainage for distal malignant biliary obstruction due to pancreatic cancer with asymptomatic duodenal invasion: a retrospective, single-center study in Japan |
| title_short | Endoscopic ultrasound-guided hepaticogastrostomy and endoscopic retrograde cholangiopancreatography-guided biliary drainage for distal malignant biliary obstruction due to pancreatic cancer with asymptomatic duodenal invasion: a retrospective, single-center study in Japan |
| title_sort | endoscopic ultrasound guided hepaticogastrostomy and endoscopic retrograde cholangiopancreatography guided biliary drainage for distal malignant biliary obstruction due to pancreatic cancer with asymptomatic duodenal invasion a retrospective single center study in japan |
| topic | duodenal invasion endoscopic retrograde cholangiopancreatography endoscopic ultrasound-guided hepaticogastrostomy malignant biliary obstruction pancreatic cancer |
| url | http://www.e-ce.org/upload/pdf/ce-2024-031.pdf |
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