Feasibility of endoscopic ultrasound-guided hepaticogastrostomy using a novel long balloon catheter

Recently, a novel long balloon catheter for tract dilation in endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) was developed. The balloon measures 6 cm in length, which enables one-step tract dilation of the gastric wall, liver parenchyma, and bile duct wall, contributing to shorter procedure times and reduced bile leakage. This study investigated the feasibility of EUS-HGS with this new balloon catheter.

This retrospective study included consecutive cases in which EUS-HGS was performed using a novel long balloon catheter (3 mm in diameter) for malignant distal biliary obstructions between February 2024 and October 2024. The patients' clinical background and procedural details were retrospectively examined using medical records. The primary outcome was technical success, defined as successful stent placement without additional dilation using devices other than the new balloon catheter. The secondary outcomes were clinical success and adverse events.

This study included 10 patients. The median age was 82.5 years, and there were seven males and three females. The median procedure time was 20 min. Technical success was achieved in 90% and clinical success was achieved in 100%. Regarding adverse events, one patient developed moderate cholecystitis, and percutaneous transhepatic gallbladder drainage was performed. No bile leakage, peritonitis, bleeding, or perforation was observed.

The new long balloon catheter is an excellent device that can reliably dilate the whole tract with a single inflation. EUS-HGS using a novel long balloon catheter is a feasible treatment option.