EUS-guided biliary drainage in patients with moderate–severe cholangitis is safe and effective: a multi-center experience

Samanta, Jayanta; Sundaram, Sridhar; Dhar, Jahnvi; Mane, Kiran; Gupta, Pankaj; Gupta, Vikas; Patil, Prachi; Sinha, Saroj Kant; Kochhar, Rakesh; Mehta, Shaesta

doi:10.1007/s00464-022-09495-1

Cited by 10 publications

(3 citation statements)

References 19 publications

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“…Following its introduction in September 2021, B2-EUS-HGS using the novel OV-EUS scope (EG-740UT) has been performed on 54 consecutive patients. Of these, nine patients were excluded in accordance with a previous report because the diameter of the targeted bile duct was <2.0 mm 15 ; the reaming 45 patients were included in this analysis ( Fig. 1 ).…”

Section: Methodsmentioning

confidence: 99%

Safety and efficacy of novel oblique-viewing scope for B2-endoscopic ultrasound-guided hepaticogastrostomy

Ishikawa,

Hara,

Okuno

et al. 2024

Clin Endosc

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Section: Methodsmentioning

confidence: 99%

Safety and efficacy of novel oblique-viewing scope for B2-endoscopic ultrasound-guided hepaticogastrostomy

Ishikawa,

Hara,

Okuno

et al. 2024

Clin Endosc

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“…However, the former carries the risk of inadequate bile aspiration and potential dislodgment of the needle tip from the bile duct, while the latter poses the risk of misplacement of the guidewire. In a conducted by Samanta et al [19], emergency EUS-BD was found to be safe in 49 cases of moderate or severe cholangitis, 87.8% of which were associated with malignancy.…”

Section: Accepted Manuscriptmentioning

confidence: 95%

Risk factors of early adverse events associated with endoscopic ultrasound-guided hepaticogastrostomy using self-expandable metal stent

Nakaji,

Takahashi,

Yoshioka

et al. 2024

Endosc Int Open

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Background and Study Aim: This retrospective study aimed to investigate risk factors for early adverse events (AEs) associated with endoscopic ultrasonography-guided hepaticogastrostomy (EUS-HGS) using self-expandable metal stents (SEMS). Patients and Methods: The clinical success rate, technical success rate, and early AEs were assessed at two hospitals from 2010 to 2022. The analysis focused on risk factors associated with cholangitis, peritonitis, and SEMS migration. Results: Technical success was achieved in all cases (94/94), and clinical success was 96.8% (91/94). Post-procedural acute cholangitis occurred in 12.8% (12/94) of cases. However, no statistically significant risk factors were identified for cholangitis or biliary tract infection. Peritonitis occurred in only 2.1% (2/94) of cases. Univariate analysis, using a 1.5 cm cut-off for the distance between the liver and gastrointestinal tract, revealed significant risk factors: braided-type SEMS, bile duct diameter (especially >4 mm), 6 mm diameter SEMS, and tract dilation (p=0.001, p=0.020, p=0.023, and p=0.046, respectively). Adjusting the cut-offs to 2 cm highlighted braided-type SEMS and tract dilation as risk factors (p=0.002 and p=0.046, respectively). With 2.5 cm cut-offs, only braided-type SEMS remained significant (p=0.018). Mortality within 14 and 30 days following EUS-HGS was 5.3% (5/94) and 16.0% (15/94), respectively. Conclusions: EUS-HGS using SEMS demonstrated high technical and clinical success rates. Laser-cut SEMS may be superior in preventing early AEs.

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“…Second, there is a blind spot for puncturing because of the distance between the ultrasound transducer and the accessory channel. This increases the probability of double puncture of the mucosa and unintended puncture of a blood vessel [13,14]. Third, it is difficult to visualize stent release and see a deployed stent in the endoscopic view, which can lead to stent misplacement [15,16].…”

Section: Introductionmentioning

confidence: 99%

Dedicated Echoendoscope for Interventional Endoscopic Ultrasound: Comparison with a Conventional Echoendoscope

Fujisawa,

Ishii,

Nakai

et al. 2024

JCM

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Interventional endoscopic ultrasound (I-EUS) is technically difficult and has risks of severe adverse events due to the scarcity of dedicated endoscopes and tools. A new EUS scope was developed for I-EUS and was modified to increase the puncture range, reduce the blind area, and overcome guidewire difficulties. We evaluated the usefulness and safety of a new EUS scope compared to a conventional EUS scope. Methods: All I-EUS procedures were performed at Juntendo University Hospital from April 2020 to April 2022. The primary outcomes included the procedure time and fluoroscopy time. The secondary outcomes included the technical success rate and the rates of procedure-related adverse events. Clinical data were retrospectively reviewed and statistically analyzed between the new and conventional EUS scopes. Results: In total, 143 procedures in 120 patients were analyzed. The procedure time was significantly shorter with the new EUS scope, but the fluoroscopy time was not different. Among the patients only undergoing EUS-guided biliary drainage (EUS-BD), 79 procedures in 74 patients were analyzed. Both the procedure time and fluoroscopy time were significantly shorter with the new EUS scope. Multivariate analysis revealed that a new EUS scope and use of covered metal stents could reduce the fluoroscopy time. The technical success rate and the adverse event rate were not significantly different between the total I-EUS and the EUS-BD only groups. However, the conventional scope showed stent deviation during stent placement, which did not happen with the new scope. Conclusions: The new EUS scope reduced procedure time for total I-EUS and fluoroscopy time for EUS-BD compared to a conventional EUS scope because of the improvement suitable for I-EUS.

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EUS-guided biliary drainage in patients with moderate–severe cholangitis is safe and effective: a multi-center experience

Cited by 10 publications

References 19 publications

Safety and efficacy of novel oblique-viewing scope for B2-endoscopic ultrasound-guided hepaticogastrostomy

Safety and efficacy of novel oblique-viewing scope for B2-endoscopic ultrasound-guided hepaticogastrostomy

Risk factors of early adverse events associated with endoscopic ultrasound-guided hepaticogastrostomy using self-expandable metal stent

Dedicated Echoendoscope for Interventional Endoscopic Ultrasound: Comparison with a Conventional Echoendoscope

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