PMID- 33398558
OWN - NLM
STAT- MEDLINE
DCOM- 20220105
LR  - 20220919
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 35
IP  - 12
DP  - 2021 Dec
TI  - Bile aspiration during EUS-guided hepaticogastrostomy is associated with lower 
      risk of postprocedural adverse events: a retrospective single-center study.
PG  - 6836-6845
LID - 10.1007/s00464-020-08189-w [doi]
AB  - BACKGROUND: In endoscopic retrograde cholangiopancreatography (ERCP), reduction 
      of pressure inside of the bile duct by bile aspiration is a well-known method to 
      lower the rate of adverse events (AEs) including cholangitis. Endoscopic 
      ultrasound-guided hepaticogastrostomy (EUS-HGS) has been introduced as an 
      alternative to ERCP. The use of self-expandable metallic stents is recommended in 
      EUS-HGS to reduce bile leak; however, other methods to reduce the rate of AEs 
      including bile leak, abdominal pain, fever, and sepsis, have not been elucidated 
      yet. This study investigated whether bile aspiration during EUS-HGS decreased the 
      rate of postprocedural AEs. METHODS: Consecutive patients who underwent EUS-HGS 
      between July 2016 and April 2020 were retrospectively evaluated in this study. 
      EUS-HGS was performed at a tertiary cancer center. Patient characteristics, site 
      of biliary obstruction, the quantity of bile aspirated during EUS-HGS, type of 
      stent, whether or not antegrade stenting (AS) was performed, procedure time, and 
      AEs were assessed based on a prospectively recorded institutional endoscopy 
      database. Logistic regression analysis was performed to identify factors 
      affecting postprocedural AEs. RESULTS: Ninety-six patients were included in the 
      study. EUS-guided HGS with and without AS was performed in 45 and 51 patients, 
      respectively. Bile was aspirated in 71 patients (74%). The quantity of bile 
      aspirated was 0-10 mL and > 10 mL in 40 and 56 patients, respectively. AEs 
      including fever, abdominal pain, postprocedural cholangitis, sepsis, acute 
      pancreatitis, and bleeding occurred in 45 patients (47%). The AE rates were 65% 
      (26/40) and 34% (19/56), for 0-10 mL and > 10 mL bile, respectively (p = 0.004). 
      Using multivariate analysis, the only independent factor affecting the occurrence 
      of AEs was found to be an aspirated bile amount of 0-10 mL (odds ratio: 4.16; 95% 
      CI 1.6-10.8). CONCLUSIONS: Bile aspiration of more than 10 mL during EUS-HGS 
      contributes to reducing the rate of postprocedural AEs.
CI  - (c) 2021. Springer Science+Business Media, LLC, part of Springer Nature.
FAU - Ishiwatari, Hirotoshi
AU  - Ishiwatari H
AD  - Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, 
      Sunto-gun, Shizuoka, Japan. ishihiro481019@gmail.com.
FAU - Satoh, Tatsunori
AU  - Satoh T
AD  - Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, 
      Sunto-gun, Shizuoka, Japan.
FAU - Sato, Junya
AU  - Sato J
AD  - Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, 
      Sunto-gun, Shizuoka, Japan.
FAU - Kaneko, Junichi
AU  - Kaneko J
AD  - Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, 
      Sunto-gun, Shizuoka, Japan.
FAU - Matsubayashi, Hiroyuki
AU  - Matsubayashi H
AD  - Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, 
      Sunto-gun, Shizuoka, Japan.
AD  - Division of Genetic Medicine Promotion, Shizuoka Cancer Center, Shizuoka, Japan.
FAU - Yabuuchi, Yohei
AU  - Yabuuchi Y
AD  - Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, 
      Sunto-gun, Shizuoka, Japan.
FAU - Kishida, Yoshihiro
AU  - Kishida Y
AD  - Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, 
      Sunto-gun, Shizuoka, Japan.
FAU - Yoshida, Masao
AU  - Yoshida M
AD  - Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, 
      Sunto-gun, Shizuoka, Japan.
FAU - Ito, Sayo
AU  - Ito S
AD  - Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, 
      Sunto-gun, Shizuoka, Japan.
FAU - Kawata, Noboru
AU  - Kawata N
AD  - Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, 
      Sunto-gun, Shizuoka, Japan.
FAU - Imai, Kenichiro
AU  - Imai K
AD  - Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, 
      Sunto-gun, Shizuoka, Japan.
FAU - Takizawa, Kohei
AU  - Takizawa K
AD  - Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, 
      Sunto-gun, Shizuoka, Japan.
FAU - Hotta, Kinichi
AU  - Hotta K
AD  - Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, 
      Sunto-gun, Shizuoka, Japan.
FAU - Ono, Hiroyuki
AU  - Ono H
AD  - Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, 
      Sunto-gun, Shizuoka, Japan.
LA  - eng
PT  - Journal Article
DEP - 20210104
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
SB  - IM
CIN - Dig Endosc. 2022 Sep;34(6):1262. PMID: 35837749
MH  - Acute Disease
MH  - Bile
MH  - Cholangiopancreatography, Endoscopic Retrograde/adverse effects
MH  - *Cholestasis/etiology/prevention & control/surgery
MH  - Drainage
MH  - Endosonography
MH  - Humans
MH  - *Pancreatitis
MH  - Retrospective Studies
MH  - Stents/adverse effects
OTO - NOTNLM
OT  - Bile aspiration
OT  - Bile leak
OT  - Cholangitis
OT  - Endoscopic ultrasound-guided biliary drainage
OT  - Sepsis
EDAT- 2021/01/06 06:00
MHDA- 2022/01/06 06:00
CRDT- 2021/01/05 06:29
PHST- 2020/06/25 00:00 [received]
PHST- 2020/11/17 00:00 [accepted]
PHST- 2021/01/06 06:00 [pubmed]
PHST- 2022/01/06 06:00 [medline]
PHST- 2021/01/05 06:29 [entrez]
AID - 10.1007/s00464-020-08189-w [pii]
AID - 10.1007/s00464-020-08189-w [doi]
PST - ppublish
SO  - Surg Endosc. 2021 Dec;35(12):6836-6845. doi: 10.1007/s00464-020-08189-w. Epub 
      2021 Jan 4.