Dilation Device Use and Concomitant Antegrade Stenting are Associated With Procedure-related Early Adverse Events After Endoscopic Ultrasound-guided Hepaticogastrostomy: A Retrospective Multicenter Study

IF 1.5 Q4 GASTROENTEROLOGY & HEPATOLOGY

DEN open Pub Date : 2025-10-07 DOI:10.1002/deo2.70211

Shinichi Hashimoto, Hiroki Taguchi, Norimasa Araki, Yu Yamazato, Hiroki Iwata, Yuji Tabira, Ryusuke Shibata, Yusuke Kamikihara, Koshiro Toyodome, Issei Kojima, Takafumi Hamada, Kengo Tsuneyoshi, Yoshitaka Nakamura, Hiroki Yano, Makoto Hinokuchi, Shiho Arima, Shiroh Tanoue, Fumisato Sasaki, Shuji Kanmura, Akio Ido

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Abstract

Objectives

Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is useful in cases of endoscopic retrograde cholangiopancreatography failure. However, the procedure has a high incidence of procedure-related early adverse events (PRAEs). This study retrospectively evaluated risk factors for such events post-EUS-HGS.

Methods

This multicenter study included 222 patients (120 males and 102 females; median age = 73 years) who underwent initial EUS-HGS. The clinical success rate and PRAE incidence, and risk factors were analyzed. PRAEs were defined as AEs occurring within 2 weeks.

Results

The median procedure time was 41 min. Metal or plastic stents were used for EUS-HGS in 107 and 115 patients, respectively. Fistula dilation and concomitant antegrade stenting (AGS) were performed in 166 and 45 patients, respectively. The clinical success rate and PRAE incidence were 85.1% and 22.1%, respectively. Identified PRAEs included acute peritonitis (9.5%), fever (6.8%), abdominal pain (2.3%), and acute pancreatitis (1.4%). Multivariate analysis identified dilation device use (p = 0.01) and AGS (p = 0.03) as PRAE risk factors. AGS in patients who underwent fistula dilation (p = 0.02) and procedure time ≥41 min in those who underwent EUS-HGS with AGS (p = 0.01) were PRAE risk factors.

Conclusions

Fistula dilation and AGS are associated with an increased risk of PRAEs post-EUS-HGS. Careful postoperative follow-up for such events is required in patients undergoing fistula dilation for EUS-HGS with AGS and prolonged procedure time.

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超声内镜引导下肝胃造口术后使用扩张装置和同时行顺行支架植入与手术相关的早期不良事件相关：一项回顾性多中心研究。

目的：超声内镜引导下肝胃造口术（EUS-HGS）在内镜下逆行胆管造影失败的病例中是有用的。然而，该手术与手术相关的早期不良事件（PRAEs）发生率很高。本研究回顾性评估eus - hgs后此类事件的危险因素。方法：这项多中心研究纳入222例患者（男性120例，女性102例，中位年龄= 73岁），这些患者首次接受EUS-HGS。分析临床成功率、PRAE发生率及危险因素。PRAEs定义为2周内发生的ae。结果：中位手术时间为41分钟。金属或塑料支架分别用于107例和115例EUS-HGS。166例患者行瘘管扩张术，45例患者行顺行支架置入术。临床成功率为85.1%，PRAE发生率为22.1%。确定的PRAEs包括急性腹膜炎（9.5%）、发热（6.8%）、腹痛（2.3%）和急性胰腺炎（1.4%）。多因素分析发现使用扩张器（p = 0.01）和AGS （p = 0.03）是PRAE的危险因素。行瘘管扩张患者发生AGS （p = 0.02）和EUS-HGS合并AGS患者手术时间≥41 min （p = 0.01）是PRAE的危险因素。结论：瘘管扩张和AGS与eus - hgs后PRAEs风险增加相关。EUS-HGS合并AGS且手术时间延长的患者，需要对此类事件进行仔细的术后随访。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

DEN open

CiteScore

1.30

自引率

0.00%

发文量