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Journal of Gastrointestinal Surgery

, Volume 22, Issue 7, pp 1312–1318 | Cite as

Clinical Impact of the Intra-scope Channel Stent Release Technique in Preventing Stent Migration During EUS-Guided Hepaticogastrostomy

  • Akira Miyano
  • Takeshi Ogura
  • Kazuhiro Yamamoto
  • Atsushi Okuda
  • Nobu Nishioka
  • Kazuhide Higuchi
Multimedia Article

Abstract

Backgrounds

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.

Aims

To examine the technical feasibility of the intra-scope channel stent release technique.

Methods

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.

Results

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.

Conclusion

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.

Keywords

Stent migration EUS Endoscopic ultrasound-guided biliary drainage EUS-guided hepaticogastrostomy Biliary drainage 

Notes

Author’s Contributions

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.

Supplementary material

11605_2018_3758_MOESM1_ESM.avi (14.7 mb)
ESM 1 (AVI 15067 kb)

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Copyright information

© The Society for Surgery of the Alimentary Tract 2018

Authors and Affiliations

  • Akira Miyano
    • 1
  • Takeshi Ogura
    • 1
  • Kazuhiro Yamamoto
    • 2
  • Atsushi Okuda
    • 1
  • Nobu Nishioka
    • 1
  • Kazuhide Higuchi
    • 1
  1. 1.2nd Department of Internal MedicineOsaka Medical CollegeTakatsukishiJapan
  2. 2.Department of RadiologyOsaka Medical CollegeOsakaJapan

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