Gunn Huh, Taehyung Lee, Jinhee Kwon, Ce Hwan Park, John J Vargo, Steven A Edmundowicz, Sunguk Jang, Do Hyun Park
{"title":"eus引导下顺行介入经壁和经吻合口塑料支架治疗良性胆肠吻合口狭窄的远期疗效（附视频）。","authors":"Gunn Huh, Taehyung Lee, Jinhee Kwon, Ce Hwan Park, John J Vargo, Steven A Edmundowicz, Sunguk Jang, Do Hyun Park","doi":"10.1097/eus.0000000000000112","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Recurrence of benign bilioenteric anastomotic strictures (BAS) is common after enteroscopy-assisted endoscopic retrograde cholangiopancreatography (ERCP), percutaneous intervention, or EUS-guided antegrade intervention (EUS-AI). This study evaluated the long-term outcomes of EUS-AI with transmural and transanastomotic stenting (TAS) following EUS-guided hepaticogastrostomy (HGS) in BAS.</p><p><strong>Methods: </strong>Consecutive patients with BAS undergoing EUS-AI with or without TAS after failed deep enteroscopy between January 2016 and June 2023 were retrospectively analyzed. The primary outcome was BAS recurrence rate after TAS removal; secondary outcomes included technical success of AI, on demand endoscopic procedure (DP) rate, the time to DP, and adverse events.</p><p><strong>Results: </strong>Among 38 patients who underwent EUS-HGS, EUS-AI succeeded in 34 (89.5%), and 28 (73.7%) proceeded to TAS. The median follow-up duration for 28 patients with TAS was 53.4 months (IQR, 22.8-85.2). During TAS placement without regular stent change, DP occurred in 43% (12/28) at a median time of 23 months. The 1-year procedure-free rate was 81.2%. After TAS removal (<i>n</i> = 12), with a median stent duration of 21.6 months, there was no BAS recurrence (0%).</p><p><strong>Conclusion: </strong>EUS-AI with indwelling TAS, without regular stent change, may offer promising long-term outcomes for BAS by reducing recurrence.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 2","pages":"79-84"},"PeriodicalIF":4.4000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080696/pdf/","citationCount":"0","resultStr":"{\"title\":\"Long-term outcomes of EUS-guided antegrade intervention with transmural and transanastomotic plastic stenting for benign bilioenteric anastomotic strictures (with video).\",\"authors\":\"Gunn Huh, Taehyung Lee, Jinhee Kwon, Ce Hwan Park, John J Vargo, Steven A Edmundowicz, Sunguk Jang, Do Hyun Park\",\"doi\":\"10.1097/eus.0000000000000112\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objectives: </strong>Recurrence of benign bilioenteric anastomotic strictures (BAS) is common after enteroscopy-assisted endoscopic retrograde cholangiopancreatography (ERCP), percutaneous intervention, or EUS-guided antegrade intervention (EUS-AI). This study evaluated the long-term outcomes of EUS-AI with transmural and transanastomotic stenting (TAS) following EUS-guided hepaticogastrostomy (HGS) in BAS.</p><p><strong>Methods: </strong>Consecutive patients with BAS undergoing EUS-AI with or without TAS after failed deep enteroscopy between January 2016 and June 2023 were retrospectively analyzed. The primary outcome was BAS recurrence rate after TAS removal; secondary outcomes included technical success of AI, on demand endoscopic procedure (DP) rate, the time to DP, and adverse events.</p><p><strong>Results: </strong>Among 38 patients who underwent EUS-HGS, EUS-AI succeeded in 34 (89.5%), and 28 (73.7%) proceeded to TAS. The median follow-up duration for 28 patients with TAS was 53.4 months (IQR, 22.8-85.2). During TAS placement without regular stent change, DP occurred in 43% (12/28) at a median time of 23 months. The 1-year procedure-free rate was 81.2%. After TAS removal (<i>n</i> = 12), with a median stent duration of 21.6 months, there was no BAS recurrence (0%).</p><p><strong>Conclusion: </strong>EUS-AI with indwelling TAS, without regular stent change, may offer promising long-term outcomes for BAS by reducing recurrence.</p>\",\"PeriodicalId\":11577,\"journal\":{\"name\":\"Endoscopic Ultrasound\",\"volume\":\"14 2\",\"pages\":\"79-84\"},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080696/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Endoscopic Ultrasound\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/eus.0000000000000112\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endoscopic Ultrasound","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/eus.0000000000000112","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/1 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Long-term outcomes of EUS-guided antegrade intervention with transmural and transanastomotic plastic stenting for benign bilioenteric anastomotic strictures (with video).
Background and objectives: Recurrence of benign bilioenteric anastomotic strictures (BAS) is common after enteroscopy-assisted endoscopic retrograde cholangiopancreatography (ERCP), percutaneous intervention, or EUS-guided antegrade intervention (EUS-AI). This study evaluated the long-term outcomes of EUS-AI with transmural and transanastomotic stenting (TAS) following EUS-guided hepaticogastrostomy (HGS) in BAS.
Methods: Consecutive patients with BAS undergoing EUS-AI with or without TAS after failed deep enteroscopy between January 2016 and June 2023 were retrospectively analyzed. The primary outcome was BAS recurrence rate after TAS removal; secondary outcomes included technical success of AI, on demand endoscopic procedure (DP) rate, the time to DP, and adverse events.
Results: Among 38 patients who underwent EUS-HGS, EUS-AI succeeded in 34 (89.5%), and 28 (73.7%) proceeded to TAS. The median follow-up duration for 28 patients with TAS was 53.4 months (IQR, 22.8-85.2). During TAS placement without regular stent change, DP occurred in 43% (12/28) at a median time of 23 months. The 1-year procedure-free rate was 81.2%. After TAS removal (n = 12), with a median stent duration of 21.6 months, there was no BAS recurrence (0%).
Conclusion: EUS-AI with indwelling TAS, without regular stent change, may offer promising long-term outcomes for BAS by reducing recurrence.
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.
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