| Featured Session 1 (JGES,JSGE,JSGS) |
| Fri. November 1st 9:00 - 11:00 Room 1: Kobe International Exhibition Hall No.2 Building Hall (North) |
| EUS-guided antegrade stenting using 22G needle combined with closure of the puncture route using self-assembling peptide solution for minimally invasive endoscopic therapy | |||
| Hirotsugu Maruyama1, Kojiro Tanoue1, Yasuhiro Fujiwara1 | |||
| 1Department of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan University | |||
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| [Aim] Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) combined with EUS-guided antegrade stenting (EUS-AS) has been reported to minimize bile leakage and prolong patency. However, problems are use of two stents and the risk of bile leakage due to the expansion operation during EUS-HGS. We report EUS-AS using a 22G needle combined with closure of the puncture route using self-assembling peptide solution for minimally invasive endoscopic therapy. [Methods] We performed EUS-AS using a 22G needle combined with closure of the puncture route using self-assembling peptide solution in 8 consecutive patients. We applied the self-assembling peptide solution using a double lumen cannula after performing EUS-AS. [Results] EUS-AS was performed using a laser-cut uncovered metallic stent and was placed across the ampulla of Vater in 4 patients and the anastomosis in 4. Five ml of self-assembling peptide solution could be simply applied in all patients. Technical and clinical success rates were 100% and 75%, respectively. The expansion operations were applied only to the gastric wall in 4 patients. Adverse events such as bile peritonitis or stent dysfunction did not occur during follow-up (median 126 days, interquartile range 72.5 - 195.5 days). No pancreatitis developed, and elevated pancreatic enzymes were in one patient. [Conclusion] This method is simple and appears to effectively avoid adverse events associated without EUS-HGS. |
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Index Term 1: EUS-HGS Index Term 2: EUS-AS |
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