A newly designed plastic stent for EUS-guided hepaticogastrostomy: a prospective preliminary feasibility study (with videos).
BACKGROUND
There are currently no dedicated plastic stents for EUS-guided hepaticogastrostomy (EUS-HGS).


OBJECTIVE
We prospectively evaluated the feasibility and the technical and functional success rates of our newly designed plastic stent for EUS-HGS.


METHODS
Prospective preliminary feasibility study.


METHODS
A tertiary-care referral center.


METHODS
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).


METHODS
An 8F single-pigtail plastic stent with 4 flanges was placed for EUS-HGS.


METHODS
Technical success, clinical success, and adverse events according to the American Society for Gastrointestinal Endoscopy lexicon.


RESULTS
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 of stent patency was 4.0 months (range 0.5-9.0 months). There was no stent migration or dislocation during the follow-up period.


CONCLUSIONS
Small number of patients and lack of a control group.


CONCLUSIONS
This newly designed single-pigtail plastic stent dedicated for EUS-HGS was technically feasible and can possibly be used for highly selected patients with advanced malignancy or benign stricture. (


BACKGROUND
http://www.umin.ac.jp/english/: UMIN000012993.).
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Junko
J
Umeda
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Takao
T
Itoi
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Takayoshi
T
Tsuchiya
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Atsushi
A
Sofuni
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Fumihide
F
Itokawa
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Kentaro
K
Ishii
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Shujiro
S
Tsuji
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Nobuhito
N
Ikeuchi
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Kentaro
K
Kamada
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Reina
R
Tanaka
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Ryosuke
R
Tonozuka
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Mitsuyoshi
M
Honjo
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Shuntaro
S
Mukai
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Mitsuru
M
Fujita
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Fuminori
F
Moriyasu
D000368:Aged; D000369:Aged, 80 and over; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D002780:Cholestasis, Intrahepatic / Q000601:surgery*; D015331:Cohort Studies; D019160:Endosonography / Q000295:instrumentation / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005774:Gastrostomy / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010969:Plastics; D011446:Prospective Studies; D015607:Stents; D013270:Stomach / Q000601:surgery*; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome
D010969:Plastics