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A newly designed plastic stent for EUS-guided hepaticogastrostomy: a prospective preliminary feasibility study (with videos)

2015; Elsevier BV; Volume: 82; Issue: 2 Linguagem: Inglês

10.1016/j.gie.2015.02.041

1097-6779

Junko Umeda, Takao Itoi, Takayoshi Tsuchiya, Atsushi Sofuni, Fumihide Itokawa, Kentaro Ishii, Shujiro Tsuji, Nobuhito Ikeuchi, Kentaro Kamada, Reina Tanaka, Ryosuke Tonozuka, Mitsuyoshi Honjo, Shuntaro Mukai, Mitsuru Fujita, Fuminori Moriyasu,

Esophageal and GI Pathology

There are currently no dedicated plastic stents for EUS-guided hepaticogastrostomy (EUS-HGS).We prospectively evaluated the feasibility and the technical and functional success rates of our newly designed plastic stent for EUS-HGS.Prospective preliminary feasibility study.A tertiary-care referral center.Twenty-three consecutive patients were treated. The reasons for requiring EUS-HGS were periampullary tumor invasion (n=9), altered anatomy (n=7), failed duodenal intubation (n=3), and previous ERCP failure (n=4).An 8F single-pigtail plastic stent with 4 flanges was placed for EUS-HGS.Technical success, clinical success, and adverse events according to the American Society for Gastrointestinal Endoscopy lexicon.All stents were successfully deployed without procedural adverse events (100% technical success rate). Bleeding from the punctured gastric wall occurred in 1 patient 3 days postoperatively. We exchanged the plastic stent for a fully covered self-expandable metal stent. A mild adverse event of self-limited abdominal pain occurred in 3 patients. Treatment success was achieved in all patients. The occlusion rate was 13.7% (3/22) during the median follow-up period (5.0 months, range 0.5-12.5 months). The median duration of stent patency was 4.0 months (range 0.5-9.0 months). There was no stent migration or dislocation during the follow-up period.Small number of patients and lack of a control group.This newly designed single-pigtail plastic stent dedicated for EUS-HGS was technically feasible and can possibly be used for highly selected patients with advanced malignancy or benign stricture. (http://www.umin.ac.jp/english/: UMIN000012993.).