Endoscopic ultrasound-guided hepaticogastrostomy and endoscopic retrograde cholangiopancreatography-guided biliary drainage for distal malignant biliary obstruction due to pancreatic cancer with asymptomatic duodenal invasion: a retrospective, single-center study in Japan.

• Tác giả: Mitsuhiro Fujishiro, Ryunosuke Hakuta, Tsuyoshi Hamada, Kazunaga Ishigaki, Yousuke Nakai, Kensaku Noguchi, Tomotaka Saito, Tatsuya Sato, Tatsunori Suzuki, Naminatsu Takahara
• Ngôn ngữ: eng
• Thông tin xuất bản: Korea (South) : Clinical endoscopy , 2025
• Bộ sưu tập: NCBI
• ID: 250986

Tóm tắt

 BACKGROUND/AIMS: Duodenal invasion (DI) is a risk factor for early recurrent biliary obstruction (RBO) in endoscopic retrograde cholangiopancreatography-guided biliary drainage (ERCP-BD). Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) may reduce early RBO in cases of asymptomatic DI, even when ERCP is possible. METHODS: We enrolled 56 patients with pancreatic cancer and asymptomatic DI who underwent EUS-HGS (n=25) or ERCP-BD (n=31). Technical and clinical success, early (<
 3 months) and overall RBO rates, time to RBO (TRBO), and adverse events were compared between the EUS-HGS and ERCP-BD groups. Risk factors for early RBO were also evaluated. RESULTS: Baseline characteristics were similar between the groups. Both procedures demonstrated 100% technical and clinical success rates, with a similar incidence of adverse events (48% vs. 39%, p=0.59). While the median TRBO was comparable (5.7 vs. 8.8 months, p=0.60), EUS-HGS was associated with a lower incidence of early RBO compared to ERCP-BD (8% vs. 29%, p=0.09). The major causes of early RBO in ERCP-BD were sludge and food impaction, rarely occurring in EUS-HGS. EUS-HGS was potentially reduced early RBO (odds ratio, 0.32
  p=0.07). CONCLUSIONS: EUS-HGS can be a viable option for treating pancreatic cancer with asymptomatic DI.