title: Stent length is impact factor associated with stent patency in endoscopic ultrasound-guided hepaticogastrostomy.
abstract: OBJECTIVE
  Despite high technical and functional success rates with endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), rates of adverse events have also been high. No reports have focused on EUS-HGS alone with a large sample size about predictors of stent patency. The present study examined predictors of stent patency in patients who underwent EUS-HGS.
  
  
  METHODS
  The consecutive 51 patients who underwent EUS-HGS using one metallic stent were retrospectively enrolled in this study. Baseline characteristics, stent length from the hepatic portion and in the luminal portion, kinds of stent dysfunction, and stent patency were reviewed.
  
  
  RESULTS
  Median duration of stent patency was significantly shorter with stent length in the luminal portion <3 cm (52 days) than with ≥3 cm (195 days; P < 0.01). On the other hand, median duration of stent patency did not differ significantly between ≥4 cm (194 days) and <4 cm (127 days; P = 0.1726). Length of stent in the luminal portion ≥3 cm (Hazard ration [HR], 9.242; 95% confidence interval [CI], 3.255-26.244, P < 0.05) and performance of chemotherapy (HR, 3.022; 95% CI, 1.448-6.304, P < 0.05) were also associated with long stent patency on the Cox proportional hazards model.
  
  
  CONCLUSIONS
  In conclusion, to obtain long-term stent patency, our data suggest that a stent length ≥3 cm in the luminal portion may be suitable for EUS-HGS.
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ogura
authors.affiliation: Department of Radiology, Osaka Medical College, Osaka, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Tatsushi
authors.initials: T
authors.lastname: Sano
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Saori
authors.initials: S
authors.lastname: Onda
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Imoto
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Masuda
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Takagi
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Fukunishi
authors.affiliation: 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Higuchi
mesh_terms: D000368:Aged; D016145:Endoscopy, Digestive System; D019160:Endosonography; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011475:Prosthesis Failure / Q000009:adverse effects; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D025321:Surgery, Computer-Assisted
keywords: EUS-FNA; EUS-guided; EUS-guided biliary drainage; endoscopic ultrasound-guided hepaticogastrostomy