Short-term results after hepaticogastrostomy guided by echo-endoscopy: Monocentric retrospective study

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Biliary Interventions

Background:

• Endoscopic ultrasound (EUS)-guided biliary drainage is an emerging technique.
• It complements existing retrograde and percutaneous approaches for biliary interventions.

Purpose of the Study:

• To evaluate the feasibility and early outcomes of EUS-guided hepaticogastrostomy (HG).
• To assess the technique's utility when standard biliary access is not possible.

Main Methods:

• Retrospective analysis of 60 EUS-guided hepaticogastrostomy (HG) procedures performed between 2000 and 2013.
• Data included patient demographics, indications, technical success, adverse events, and stent types.

Main Results:

• The technical success rate for HG was 94% in 60 patients, predominantly with neoplastic strictures (85%).
• Adverse events occurred in 28% of patients, including infection and bilioma. Stent migration occurred in 11%.
• Complication rates varied by stent type, with plastic stents showing 33% and half-covered metallic stents 13%.

Conclusions:

• EUS-guided hepaticogastrostomy is effective for biliary drainage when retrograde access fails or for selective left duct drainage.
• The technique demonstrates a high but potentially decreasing morbidity rate.