Simplified fistula dilation technique and modified stent deployment maneuver for EUS-guided hepaticogastrostomy

Table 1 Baseline characteristics of the study population n (%)

Characteristics	EUS-BD (n = 28)
Median age (range, yr)	63 (29-87)
Male	20 (71)
Indication
Malignant (n = 25)
Cholangiocarcinoma	10
Pancreatic cancer	5
Gallbladder cancer	2
Stomach cancer	2
Ampulla of Vater cancer	1
Colon cancer	1
Duodenal cancer	1
Hepatocellular carcinoma	1
Intraductal papillary neoplasm of bile duct	1
Lymphoma	1
Benign (n = 3)
Benign IHD stricture	1
Postoperative anastomosis site stricture	1
IgG4-related sclerosing cholangitis	1
Surgically altered anatomy	6 (21)

EUS-BD: Endoscopic ultrasonography-guided biliary drainage.

Table 2 Outcome of endoscopic ultrasonography-guided hepaticogastrostomy n (%)

Outcome	EUS-HGS (n = 28)
Technical success rate	27 (96)
Clinical success rate	24 (89)
Median length of stent (range), cm	8.5 (5-10)
Procedure time, mean ± SD, min	15.6 ± 5.8
Median stent patency (95%CI), d	150 (5-295)
Early adverse event	0
Late adverse event	2 (7)
Overall survival (95%CI), mo	7.5 (5.0-12.0)

Late adverse events: Pseudoaneurysm (1), partial distal migration (1). Data are expressed as n (%) or mean ± SD. EUS-HGS: Endoscopic ultrasonography-guided hepaticogastrostomy.

Table 3 Age and etiology matched case-control results n (%)

Characteristics	Modified method(n = 23)	Conventional method(n = 23)	P value
Age mean ± SD, yr	62.9 ± 14.6	64.1 ± 12.8	0.88
Male	17 (74)	12 (52)	0.13
Etiology of bile duct obstruction			> 0.99
Benign	1	1
Perihilar lesion	15	15
Periampullary lesion	5	5
Peribiliary or metastatic lymph node	2	2
Surgically altered anatomy	6	6	> 0.99
Failed guidewire manipulation during ERCP or EUS-guided rendezvous	9	7	0.54
Technical success rate1	22 (96)	21 (91)	> 0.99
Functional success rate2	20 (91)	16 (76)	0.24
% of needle knife use in two groups	1 (4)	1 (4)	> 0.99
Procedure time, mean ± SD, min	15.3 ± 5.2	22.3 ± 6.0	< 0.001
Median stent patency (95%CI), d	216 (73-359)	129 (64-194)	0.73
Total adverse event (%)	2 (9)	8 (35)	0.07
Early	0	6 (26)3	0.02
Late	2 (9)	2 (9)4	> 0.99
Overall survival (95%CI), mo	7.5 (5.6-9.4)	4.3 (1.8-6.8)	0.27

¹Intention-to-treat analysis;

²Per-protocol analysis;

³Pneumoperitoneum (2), proximal migration (1), partial proximal migration (1), partial distal migration (1), abdominal pain (1);

⁴Distal migration (2).