Clinical Impact of the Intra-scope Channel Stent Release Technique in Preventing Stent Migration During EUS-Guided Hepaticogastrostomy
Stent migration following endoscopic ultrasonography-guided hepaticogastrostomy (EUS-HGS) may sometimes be fatal because there are no adhesions between the biliary tract and stomach. To prevent stent migration and minimize the stent length in the abdominal cavity, we recently performed EUS-HGS using the technique of releasing the stent within the scope channel.
To examine the technical feasibility of the intra-scope channel stent release technique.
Forty-one consecutive patients who underwent EUS-HGS were enrolled. Between October 2015 and December 2015, EUS-HGS was performed using the extra-scope channel release technique, while the intra-scope channel release technique was performed between January 2016 and March 2016.
The distance between the hepatic parenchyma and the stomach wall after EUS-HGS in the intra-scope channel stent release group was significantly shorter than that in the extra-scope channel release group (0.66 ± 1.25 vs 2.52 ± 0.97, P < 0.05). Adverse events, such as biloma or stent migration, were seen in only the extra-scope channel release group.
In conclusion, although additional cases and randomized controlled studies using metal stents of various lengths are needed, our technique is likely to be clinically useful for the prevention of early and late stent migration.
KeywordsStent migration EUS Endoscopic ultrasound-guided biliary drainage EUS-guided hepaticogastrostomy Biliary drainage
Akira Miyano and Takeshi Ogura wrote the paper. Takeshi Ogura, Kazuhiro Yamamoto, Atsushi Okuda, Nobu Nishioka, and Kazuhide Higuchi played roles in interpretation of data for the work, revising it critically for important intellectual content, final approval of the version to be published, and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
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