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Updated: Jun 16, 2026

Intraoperative Video Consultation Following Bile Duct Transection Facilitates Direct OR Transfer for Robotic Hepaticojejunostomy at Tertiary Center

Intraoperative Video Consultation Following Bile Duct Transection Facilitates Direct OR Transfer for Robotic Hepaticojejunostomy at Tertiary Center

Published on: January 9, 2026

Time to endosonography-created route formation after EUS-guided hepaticojejunostomy for performing antegrade

Kimi Bessho^1,2, Takeshi Ogura^1,2,3, Akitoshi Hakoda²

¹Pancreatobiliary Advanced Medical Center, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan.

Endoscopic Ultrasound

|June 15, 2026

Abstract

Background And Objectives:

The antegrade procedure can be safely performed via an endosonography-created route (ESCR). Among the various types of surgically altered anatomy, antegrade procedures are frequently attempted in patients with Roux-en-Y (RY) anastomosis. For patients with RY anastomosis, EUS-guided hepaticojejunostomy (EUS-HJS) can be performed. However, evidence of the technical feasibility and safety of EUS-HJS is still limited, and there is no evidence of the time required for definitive formation of the ESCR after EUS-HJS. In the present study, we evaluated the time to formation of the ESCR after EUS-HJS for safely performing antegrade procedures.

Method:

Patients in whom EUS-HJS was attempted were eligible for study enrollment. The primary outcome of the present study was to evaluate the time to ESCR creation after EUS-HJS. This time was measured from the day of EUS-HJS to HJS stent removal. The technical success rates of EUS-HJS, HJS stent removal, the trans-ESCR procedure, and adverse events were secondarily evaluated.

Results:

A total of 42 patients were enrolled in the present study. The median interval prior to EUS-HJS stent removal was 10 days (range, 7-19 days). ESCR formation was confirmed in all patients who underwent EUS-HJS stent removal (100%, 42/42). The technical success rate of the subsequent trans-ESCR procedure was 95.2% (40/42). ESCR broken was not observed during procedures.

Conclusions:

In conclusion, sufficient formation of the ESCR for performing antegrade procedures might occur within 10 days after EUS-HJS in patients with RY anastomosis.

Keywords:

Antegrade intervention ERCP ESCR EUS-HJS Stent removal

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