Efficacy and safety of endoscopic ultrasound-guided hepaticogastrostomy for biliary drainage in hypervascular hepatocellular carcinoma: a retrospective study from Japan

Background/Aims Biliary obstruction drainage in patients with hepatocellular carcinoma (HCC) is associated with symptom palliation, improved access to chemotherapy, and improved survival. Stent placement and exchange via endoscopic retrograde cholangiopancreatography biliary drainage risk traversing...

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Main Authors: Kenneth Tachi, Kazuo Hara, Nozomi Okuno, Shin Haba, Takamichi Kuwahara, Toshitaka Fukui, Ahmed Mohammed Sadek, Hossam El-Din Shaaban Mahmoud Ibrahim, Minako Urata, Takashi Kondo, Yoshitaro Yamamoto
Format: Article
Language:English
Published: Korean Society of Gastrointestinal Endoscopy 2025-05-01
Series:Clinical Endoscopy
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Online Access:http://e-ce.org/upload/pdf/ce-2024-079.pdf
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author Kenneth Tachi
Kazuo Hara
Nozomi Okuno
Shin Haba
Takamichi Kuwahara
Toshitaka Fukui
Ahmed Mohammed Sadek
Hossam El-Din Shaaban Mahmoud Ibrahim
Minako Urata
Takashi Kondo
Yoshitaro Yamamoto
author_facet Kenneth Tachi
Kazuo Hara
Nozomi Okuno
Shin Haba
Takamichi Kuwahara
Toshitaka Fukui
Ahmed Mohammed Sadek
Hossam El-Din Shaaban Mahmoud Ibrahim
Minako Urata
Takashi Kondo
Yoshitaro Yamamoto
author_sort Kenneth Tachi
collection DOAJ
description Background/Aims Biliary obstruction drainage in patients with hepatocellular carcinoma (HCC) is associated with symptom palliation, improved access to chemotherapy, and improved survival. Stent placement and exchange via endoscopic retrograde cholangiopancreatography biliary drainage risk traversing the HCC, a hypervascular tumor and causing bleeding. Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) potentially prevents procedure-related bleeding. Therefore, we evaluated the efficacy and safety of EUS-HGS as an alternative treatment for biliary obstruction in patients with HCC. Methods This was a retrospective study of all EUS-HGS procedures performed in patients with HCC at the Aichi Cancer Center Hospital, Japan, from February 2017 to August 2023. Results A total of 14 EUS-HGS procedures (42.9% primary) were attempted in 10 HCC patients (mean age 71.5 years, 80.0% male). Clinical and technical success rates were 92.9% and 90.9%, respectively. The observed procedure details in the 13 successful procedures included B3 puncture (53.8%), 22-G needle (53.8%), fully covered self-expandable metal stent (100%), and mean procedure time (32.7 minutes). There was no bleeding. Mild complications occurred in 27.3%. All patients resumed oral intake within 24 hours. Conclusions EUS-HGS is a technically feasible and clinically effective initial or salvage drainage option for the treatment of biliary obstruction in patients with HCC.
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spelling doaj-art-eaf195864c824a30a0aea6468f4ce7de2025-08-20T03:33:25ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432025-05-0158344845610.5946/ce.2024.0797940Efficacy and safety of endoscopic ultrasound-guided hepaticogastrostomy for biliary drainage in hypervascular hepatocellular carcinoma: a retrospective study from JapanKenneth TachiKazuo HaraNozomi OkunoShin HabaTakamichi KuwaharaToshitaka FukuiAhmed Mohammed SadekHossam El-Din Shaaban Mahmoud IbrahimMinako UrataTakashi KondoYoshitaro YamamotoBackground/Aims Biliary obstruction drainage in patients with hepatocellular carcinoma (HCC) is associated with symptom palliation, improved access to chemotherapy, and improved survival. Stent placement and exchange via endoscopic retrograde cholangiopancreatography biliary drainage risk traversing the HCC, a hypervascular tumor and causing bleeding. Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) potentially prevents procedure-related bleeding. Therefore, we evaluated the efficacy and safety of EUS-HGS as an alternative treatment for biliary obstruction in patients with HCC. Methods This was a retrospective study of all EUS-HGS procedures performed in patients with HCC at the Aichi Cancer Center Hospital, Japan, from February 2017 to August 2023. Results A total of 14 EUS-HGS procedures (42.9% primary) were attempted in 10 HCC patients (mean age 71.5 years, 80.0% male). Clinical and technical success rates were 92.9% and 90.9%, respectively. The observed procedure details in the 13 successful procedures included B3 puncture (53.8%), 22-G needle (53.8%), fully covered self-expandable metal stent (100%), and mean procedure time (32.7 minutes). There was no bleeding. Mild complications occurred in 27.3%. All patients resumed oral intake within 24 hours. Conclusions EUS-HGS is a technically feasible and clinically effective initial or salvage drainage option for the treatment of biliary obstruction in patients with HCC.http://e-ce.org/upload/pdf/ce-2024-079.pdfcholangitisendosonographyfibrosishepatocellular carcinomaobstructive jaundice
spellingShingle Kenneth Tachi
Kazuo Hara
Nozomi Okuno
Shin Haba
Takamichi Kuwahara
Toshitaka Fukui
Ahmed Mohammed Sadek
Hossam El-Din Shaaban Mahmoud Ibrahim
Minako Urata
Takashi Kondo
Yoshitaro Yamamoto
Efficacy and safety of endoscopic ultrasound-guided hepaticogastrostomy for biliary drainage in hypervascular hepatocellular carcinoma: a retrospective study from Japan
Clinical Endoscopy
cholangitis
endosonography
fibrosis
hepatocellular carcinoma
obstructive jaundice
title Efficacy and safety of endoscopic ultrasound-guided hepaticogastrostomy for biliary drainage in hypervascular hepatocellular carcinoma: a retrospective study from Japan
title_full Efficacy and safety of endoscopic ultrasound-guided hepaticogastrostomy for biliary drainage in hypervascular hepatocellular carcinoma: a retrospective study from Japan
title_fullStr Efficacy and safety of endoscopic ultrasound-guided hepaticogastrostomy for biliary drainage in hypervascular hepatocellular carcinoma: a retrospective study from Japan
title_full_unstemmed Efficacy and safety of endoscopic ultrasound-guided hepaticogastrostomy for biliary drainage in hypervascular hepatocellular carcinoma: a retrospective study from Japan
title_short Efficacy and safety of endoscopic ultrasound-guided hepaticogastrostomy for biliary drainage in hypervascular hepatocellular carcinoma: a retrospective study from Japan
title_sort efficacy and safety of endoscopic ultrasound guided hepaticogastrostomy for biliary drainage in hypervascular hepatocellular carcinoma a retrospective study from japan
topic cholangitis
endosonography
fibrosis
hepatocellular carcinoma
obstructive jaundice
url http://e-ce.org/upload/pdf/ce-2024-079.pdf
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