Utility of endoscopic ultrasound-guided hepaticoduodenostomy for intrahepatic bile duct drainage: a multicenter retrospective study in Western Japan.

BACKGROUND

There are several biliary drainage procedures for biliary strictures, including endoscopic ultrasound-guided hepaticoduodenostomy (EUS-HDS). This multicenter retrospective study evaluated the safety and clinical outcomes of EUS-HDS for intrahepatic bile duct drainage.

METHODS

Consecutive patients who underwent EUS-HDS at 12 Japanese referral centers between January 2010 and December 2024 were enrolled. The primary endpoint was clinical success. Secondary endpoints were technical success, stent patency, and adverse events.

RESULTS

Thirty-five patients were analyzed. Perihilar biliary stenosis was observed in 91.4%, and right posterior sectoral bile ducts were targeted in 80.0%. Technical and clinical success rates were 88.6% and 68.6%, respectively. The cumulative incidence of stent occlusion was 6.7% at 30 days, 13.3% at 90 days, and 20.0% at 180 days. One case of mild peritonitis occurred.

CONCLUSIONS

EUS-HDS appears to be a feasible and safe option for selected patients with malignant intrahepatic biliary obstruction and may provide clinical benefit as part of a complementary drainage strategy.