DEN open · 2026
Comparison of Two Partially Covered Metal Stents for Endoscopic Ultrasound-guided Hepaticogastrostomy: A Multi-Center Retrospective Study.
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Yamamura Masahiro, Ishiwatari Hirotoshi, Matsubara Saburo, Okamoto Takeshi, Ono Michihiro, Okuda Toshinori, Ishida Etsuji, Takada Kohichi, Ishikawa Kazuma, Sasahira Naoki, Suda Kentaro, Ikeda Morito, Watanabe Daichi, Sato Junya, Sakamoto Hiroki, Ohba Akihiro, Doi Takuya, Notsu Akifumi
Аннотация
OBJECTIVES: Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is an alternative biliary drainage method after failed endoscopic retrograde cholangiopancreatography. Nevertheless, it is associated with adverse events (AEs), including peritonitis and stent migration. The influence of metallic stent (MS) design characteristics, including axial force (AF), on the safety and efficacy of EUS-HGS remains unclear.
METHODS: This multicenter retrospective study included patients with unresectable malignant biliary obstruction who underwent EUS-HGS using either a high-AF MS (Niti-S biliary S-type) or a low-AF MS (EGIS biliary) between January 2019 and December 2022. Propensity score matching was performed in a 1:2 ratio. Outcomes included clinical success, early and late non-recurrent biliary obstruction (non-RBO) AEs, RBO, time to RBO (TRBO), and overall survival (OS).
RESULTS: After matching, 27 patients in the high-AF group and 54 in the low-AF group were analyzed. Clinical success, RBO rate, TRBO, OS, and late non-RBO AE rates were similar between groups. However, early non-RBO AEs were more frequent in the high-AF group (37% vs. 13%, p = 0.02).
CONCLUSIONS: Of the two partially covered MSs evaluated, the EGIS biliary stent demonstrated fewer early non-RBO AEs after EUS-HGS.
METHODS: This multicenter retrospective study included patients with unresectable malignant biliary obstruction who underwent EUS-HGS using either a high-AF MS (Niti-S biliary S-type) or a low-AF MS (EGIS biliary) between January 2019 and December 2022. Propensity score matching was performed in a 1:2 ratio. Outcomes included clinical success, early and late non-recurrent biliary obstruction (non-RBO) AEs, RBO, time to RBO (TRBO), and overall survival (OS).
RESULTS: After matching, 27 patients in the high-AF group and 54 in the low-AF group were analyzed. Clinical success, RBO rate, TRBO, OS, and late non-RBO AE rates were similar between groups. However, early non-RBO AEs were more frequent in the high-AF group (37% vs. 13%, p = 0.02).
CONCLUSIONS: Of the two partially covered MSs evaluated, the EGIS biliary stent demonstrated fewer early non-RBO AEs after EUS-HGS.