Safety of endoscopic ultrasound-guided hepaticogastrostomy in patients with malignant biliary obstruction and ascites.

IF 2.1 Q3 GASTROENTEROLOGY & HEPATOLOGY
Clinical Endoscopy Pub Date : 2024-03-01 Epub Date: 2023-09-07 DOI:10.5946/ce.2023.075
Tsukasa Yasuda, Kazuo Hara, Nobumasa Mizuno, Shin Haba, Takamichi Kuwahara, Nozomi Okuno, Yasuhiro Kuraishi, Takafumi Yanaidani, Sho Ishikawa, Masanori Yamada, Toshitaka Fukui
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引用次数: 0

Abstract

Background/aims: Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (EUS-HGS) is useful for patients with biliary cannulation failure or inaccessible papillae. However, it can lead to serious complications such as bile peritonitis in patients with ascites; therefore, development of a safe method to perform EUS-HGS is important. Herein, we evaluated the safety of EUS-HGS with continuous ascitic fluid drainage in patients with ascites.

Methods: Patients with moderate or severe ascites who underwent continuous ascites drainage, which was initiated before EUS-HGS and terminated after the procedure at our institution between April 2015 and December 2022, were included in the study. We evaluated the technical and clinical success rates, EUS-HGS-related complications, and feasibility of re-intervention.

Results: Ten patients underwent continuous ascites drainage, which was initiated before EUS-HGS and terminated after completion of the procedure. Median duration of ascites drainage before and after EUS-HGS was 2 and 4 days, respectively. Technical success with EUS-HGS was achieved in all 10 patients (100%). Clinical success with EUS-HGS was achieved in 9 of the 10 patients (90 %). No endoscopic complications such as bile peritonitis were observed.

Conclusion: In patients with ascites, continuous ascites drainage, which is initiated before EUS-HGS and terminated after completion of the procedure, may prevent complications and allow safe performance of EUS-HGS.

内镜下超声引导肝胃造口术治疗恶性胆道梗阻和腹水患者的安全性。
背景/目的:内镜超声(EUS)引导下肝胃造口术(EUS-HGS)适用于胆道插管失败或乳头无法触及的患者。然而,它会导致严重的并发症,如腹水患者的胆汁性腹膜炎;因此,开发一种安全的方法来执行EUS-HGS是重要的。在此,我们评估了EUS-HGS持续腹水引流治疗腹水患者的安全性。方法:将2015年4月至2022年12月在我院接受EUS-HGS前开始并在手术后终止的中重度腹水患者纳入研究。我们评估了技术和临床成功率、EUS-HGS相关并发症以及再干预的可行性。结果:10名患者接受了持续腹水引流,该引流在EUS-HGS之前开始,在手术完成后终止。EUS-HGS前后腹水引流的中位持续时间分别为2天和4天。EUS-HGS在所有10名患者中均取得了技术成功(100%)。EUS-HGS在10名患者中有9名(90%)取得了临床成功。未观察到胆汁性腹膜炎等内镜并发症。结论:在腹水患者中,在EUS-HGS之前开始并在手术完成后终止的持续腹水引流可以预防并发症,并允许EUS-HGS的安全运行。
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来源期刊
Clinical Endoscopy
Clinical Endoscopy GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.40
自引率
8.00%
发文量
95
审稿时长
26 weeks
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