| International Session（Workshop）2(JGES・JSGE・JSH) |
| Fri. November 1st 9:00 - 12:00 Room 11: Portopia Hotel South Wing Topaz |
| Efficacy and safety of EUS-guided hepaticogastrostomy for biliary drainage in hepatocellular carcinoma and cirrhosis | |||
| Yoshitaro Yamamoto1, Nozomi Okuno1, Kazuo Hara1 | |||
| 1Department of Gastroenterology, Aichi Cancer Center | |||
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| Background / Aims: Endoscopic biliary stenting by ERCP for hepatocellular carcinoma (HCC) patients has risk of bleeding due to its abundant blood flow. Even if reintervention, there is also a risk of bleeding. In this point of view, EUS-HGS has the advantage of biliary drainage without transversing the tumor. We evaluated the efficacy and safety of EUS-HGS as option for biliary obstruction in HCC patients. Methods: Between February 2017 and August 2023, 14 EUS-HGS procedures in 10 patients with obstructive jaundice due to HCC were enrolled and retrospectively reviewed. Results: One patient had 2 procedures performed on the same day, while 3 patients had repeat procedures on different days. 50% (5/10) had background cirrhosis. Ascites was present in 5 cases of 10 cases. The anatomical level of biliary obstruction was classified 7 hepatic hilum, 2 hepatic hilum+ intrahepatic, and 1 intrahepatic bile duct. Technical and clinical success rate was 92.9% and 90.9%. The observed procedure details in the 13 successful procedures included, B3 puncture - 53.8%, 22G needle - 53.8%, using FCSEMS - 100% and mean procedure time 32.7 minutes. There was no bleeding, only mild complications were seen in 27.3% (3/13) (1 cholecystitis /2 fever). All patients resumed feeding within 24 hours. Conclusion: Even HCC and cirrhosis, EUS-HGS is a bleeding-free, technically feasible and clinically effective primary or salvage drainage option for malignant biliary obstructions. |
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Index Term 1: Endoscopic ultrasound guided hepaticogastrostomy Index Term 2: Hepatocellular carcinoma |
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