Brief Article
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World J Gastroenterol. May 7, 2014; 20(17): 5051-5059
Published online May 7, 2014. doi: 10.3748/wjg.v20.i17.5051
Simplified fistula dilation technique and modified stent deployment maneuver for EUS-guided hepaticogastrostomy
Woo Hyun Paik, Do Hyun Park, Jun-Ho Choi, Joon Hyuk Choi, Sang Soo Lee, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim, Jung Bok Lee
Woo Hyun Paik, Do Hyun Park, Jun-Ho Choi, Joon Hyuk Choi, Sang Soo Lee, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim, Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736, South Korea
Woo Hyun Paik, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Koyang 411-706, South Korea
Jung Bok Lee, Department of Clinical Epidemiology and Biostatics, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736, South Korea
Author contributions: Paik WH performed the research, analyzed the data and wrote the manuscript; Park DH designed the research, analyzed the data and contributed to the preparation, editing, and final approval of the manuscript; Choi JH and Choi JH wrote the manuscript; Lee SS, Seo DW, Lee SK and Kim MH contributed to the preparation, recruitment of patients and final approval of the manuscript; Lee JB was involved in the statistical analysis of the study.
Correspondence to: Do Hyun Park, MD, PhD, Associate Professor, Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-Ro 43-Gil, Songpa-gu, Seoul 138-736, South Korea. dhpark@amc.seoul.kr
Telephone: +82-2-30103194 Fax: +82-2-30108043
Received: November 21, 2013
Revised: January 5, 2014
Accepted: February 17, 2014
Published online: May 7, 2014
Core Tip

Core tip: Endoscopic ultrasonography-guided hepaticogastrostomy (EUS-HGS) with direct transluminal stenting is a complex procedure in terms of guidewire manipulation, fistula dilation and stent deployment. We prospectively evaluated our simplified and modified EUS-HGS technique; fistula dilation with a 4 mm balloon dilation catheter with a stainless steel stylet and stent deployment maneuver with an 8 mm fully covered metal stent with dual flaps. The technical and clinical success was 96% (27/28) and 89% (24/27). The overall adverse event rate was 7%. Compared with the conventional EUS-HGS technique, the procedural time was shorter and early adverse events were less frequent with our modified technique.