Enhanced Endoscope is Associated With Success Rates in B2- Endoscopic Ultrasound-Guided Hepaticogastrostomy

Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS) in intrahepatic bile duct segment 3 (B3) is widely used for biliary drainage. Post-puncture procedures are easy to perform in intrahepatic bile duct segment 2 (B2), but using a conventional oblique-viewing (OV) scope (GF-UCT260) may result in transesophageal puncture. In this study, we compared the safety and efficacy of B2 puncture using a conventional OV scope, a novel OV scope (EG-740UT), and a forward-viewing (FV) scope (TGF-UC260J).

This single-center retrospective study investigated 319 consecutive patients in whom B2-EUS-HGS was attempted using an OV or FV between January 2017 and March 2024 at Aichi Cancer Center.

In B2-EUS-HGS, the use of enhanced endoscopes (TGF-UC260J and EG-740UT) resulted in a relatively high technical success rate of 93.6% (205/219) and an overall clinical success rate of 97.1% (199/205). The enhanced endoscope group demonstrated a significantly higher technical success rate (p < 0.001) compared to the conventional endoscope group. No significant differences were observed between the two groups in terms of overall clinical success rate (p = 0.128) and early adverse event rate (p = 0.461).

B2-EUS-HGS using either an FV or novel OV scope showed comparable safety with a high technical and overall clinical success rate. The use of an FV or novel OV scope seems to be a suitable strategy for performing B2-EUS-HGS.

Study/trial registration and registration number were not applicable (N/A), as this study was a retrospective analysis using anonymized data.