Impact of self-expandable metal stent deployment site on stent dysfunction during EUS-guided hepaticogastrostomy.

IF 4.4 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Endoscopic Ultrasound Pub Date : 2025-01-01 Epub Date: 2025-02-27 DOI:10.1097/eus.0000000000000100

Takeshi Ogura, Saori Ueno, Atsushi Okuda, Nobu Nishioka, Jun Sakamoto, Masanori Yamada, Masahiro Yamamura, Yuki Uba, Mitsuki Tomita, Nobuhiro Hattori, Junichi Nakamura, Kimi Bessho, Hiroki Nishikawa

{"title":"Impact of self-expandable metal stent deployment site on stent dysfunction during EUS-guided hepaticogastrostomy.","authors":"Takeshi Ogura, Saori Ueno, Atsushi Okuda, Nobu Nishioka, Jun Sakamoto, Masanori Yamada, Masahiro Yamamura, Yuki Uba, Mitsuki Tomita, Nobuhiro Hattori, Junichi Nakamura, Kimi Bessho, Hiroki Nishikawa","doi":"10.1097/eus.0000000000000100","DOIUrl":null,"url":null,"abstract":"Background and objectives: Hyperplasia at the distal side of an EUS-guided hepaticogastrostomy (HGS) stent is one of the most frequent causes of stent dysfunction. However, risk factors for hyperplasia during EUS-HGS remain unclear. The aim of the present study was to determine the most appropriate stent site during EUS-HGS to obtain prolonged stent patency.Method: This study included 100 consecutive patients who underwent successful EUS-HGS using a partially covered, self-expandable, metal stent (PCSEMS) between January 2017 and September 2022. The patients were divided into 2 groups according to the distal site of the PCSEMS at the intrahepatic bile duct, the peripheral side group and the central side group.Results: There were 30 patients in the peripheral side group and 70 in the central side group. The diameter of the intrahepatic bile duct at the PCSEMS deployment site was significantly greater in the central side group (mean 7.90 mm) than in the peripheral side group (mean 4.25 mm; P < 0.05). Stent patency was significantly longer in the central side group than in the peripheral side group (median, 60 days vs. 144 days, P = 0.011), although overall survival was not significantly different. Hyperplasia was significantly more frequent in the peripheral side group. On multivariate analysis, the site of the PCSEMS (peripheral) was the only risk factor for stent dysfunction.Conclusions: In conclusion, the distal site of the PCSEMS deployed at the hepatic hilar site from the confluence between B2 and B3 might play a role in obtaining longer stent patency.","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 1","pages":"26-32"},"PeriodicalIF":4.4000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939943/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endoscopic Ultrasound","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/eus.0000000000000100","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/27 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background and objectives: Hyperplasia at the distal side of an EUS-guided hepaticogastrostomy (HGS) stent is one of the most frequent causes of stent dysfunction. However, risk factors for hyperplasia during EUS-HGS remain unclear. The aim of the present study was to determine the most appropriate stent site during EUS-HGS to obtain prolonged stent patency.

Method: This study included 100 consecutive patients who underwent successful EUS-HGS using a partially covered, self-expandable, metal stent (PCSEMS) between January 2017 and September 2022. The patients were divided into 2 groups according to the distal site of the PCSEMS at the intrahepatic bile duct, the peripheral side group and the central side group.

Results: There were 30 patients in the peripheral side group and 70 in the central side group. The diameter of the intrahepatic bile duct at the PCSEMS deployment site was significantly greater in the central side group (mean 7.90 mm) than in the peripheral side group (mean 4.25 mm; P < 0.05). Stent patency was significantly longer in the central side group than in the peripheral side group (median, 60 days vs. 144 days, P = 0.011), although overall survival was not significantly different. Hyperplasia was significantly more frequent in the peripheral side group. On multivariate analysis, the site of the PCSEMS (peripheral) was the only risk factor for stent dysfunction.

Conclusions: In conclusion, the distal site of the PCSEMS deployed at the hepatic hilar site from the confluence between B2 and B3 might play a role in obtaining longer stent patency.

查看原文本刊更多论文

背景和目的：EUS 导向肝胃造口术（HGS）支架远端增生是导致支架功能障碍的最常见原因之一。然而，EUS-HGS 期间增生的风险因素仍不清楚。本研究旨在确定 EUS-HGS 期间最合适的支架部位，以延长支架的通畅时间：本研究纳入了 2017 年 1 月至 2022 年 9 月期间使用部分覆盖、自扩金属支架（PCSEMS）成功接受 EUS-HGS 的 100 例连续患者。根据 PCSEMS 在肝内胆管的远端部位将患者分为两组，即外周侧组和中央侧组：结果：外周侧组有30名患者，中心侧组有70名患者。中央侧组的 PCSEMS 部署部位肝内胆管的直径（平均 7.90 毫米）明显大于外周侧组（平均 4.25 毫米；P < 0.05）。中央侧组的支架通畅时间明显长于外周侧组（中位数，60 天 vs. 144 天，P = 0.011），但总体存活率没有明显差异。外周侧组血管增生的发生率明显更高。多变量分析显示，PCSEMS的部位（外周）是支架功能障碍的唯一风险因素：总之，从 B2 和 B3 交汇处肝门部位部署 PCSEMS 的远端部位可能有助于获得更长的支架通畅时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Endoscopic Ultrasound GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

6.20

自引率

11.10%

发文量

144

期刊介绍： Endoscopic Ultrasound, a publication of Euro-EUS Scientific Committee, Asia-Pacific EUS Task Force and Latin American Chapter of EUS, is a peer-reviewed online journal with Quarterly print on demand compilation of issues published. The journal’s full text is available online at http://www.eusjournal.com. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository. The journal does not charge for submission, processing or publication of manuscripts and even for color reproduction of photographs.