PMID- 35680668 OWN - NLM STAT- MEDLINE DCOM- 20221115 LR - 20231220 IS - 1432-2218 (Electronic) IS - 0930-2794 (Linking) VI - 36 IP - 12 DP - 2022 Dec TI - Long-term outcomes and predictors of adverse events of EUS-guided hepatico-gastrostomy for malignant biliary obstruction: Multicenter, retrospective study. PG - 8950-8958 LID - 10.1007/s00464-022-09346-z [doi] AB - BACKGROUND AND AIMS: Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS) may be a feasible and useful alternative in patients with malignant biliary obstruction (MBO) after failed endoscopic retrograde cholangiopancreatography (ERCP). To date, the risk factors for adverse events (AEs) and long-term outcomes of EUS-HGS have not been fully explored according to stent type. Therefore, we evaluated potential risk factors for AEs and long-term outcomes of EUS-HGS. METHODS: In total, 120 patients who underwent EUS-HGS were retrospectively reviewed. A multivariate analysis through Cox proportional hazard and logistic regression model was used to identify the risk factors for stent dysfunction and AEs, respectively. Stent patency and patient survival were evaluated using Kaplan-Meier plots with a log-rank test for each stent. RESULTS: The technical and clinical success rates were 96.2% (102/106) and 83.0% (88/106). The median duration of stent patency was longer in self-expandable metal stents (SEMS) compared to plastic stents (PS) (158 vs. 108 days). Kaplan-Meier analysis indicated that the type of stent was not associated with stent patency (Hazard ratios [HR] 0.997, 95% confidence interval [CI] [0.525-1.896]) or overall survival. In addition, multivariate analysis indicated that hilar MBO significantly associated with stent dysfunction (HR, 2.340; 95% CI, 1.028-5.326, p = 0.043) and late AEs. CONCLUSIONS: Given the lower incidence of AEs and better long-term outcomes of EUS-HGS, it can be considered a safe alternative to ERCP or percutaneous approaches regardless of which stent is used. Furthermore, hilar MBO was established as a potential risk factor for stent dysfunction and late AEs. CI - (c) 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. FAU - Cho, Jae Hee AU - Cho JH AD - Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea. FAU - Park, Se Woo AU - Park SW AUID- ORCID: 0000-0001-6531-4076 AD - Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 18450, South Korea. mdsewoopark@gmail.com. FAU - Kim, Eui Joo AU - Kim EJ AD - Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea. FAU - Park, Chan Hyuk AU - Park CH AD - Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea. FAU - Park, Da Hae AU - Park DH AD - Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 18450, South Korea. FAU - Lee, Kyong Joo AU - Lee KJ AD - Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 18450, South Korea. FAU - Lee, Sang Soo AU - Lee SS AD - Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil Songpa-gu, Seoul, 05505, South Korea. euslove68@gmail.com. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20220609 PL - Germany TA - Surg Endosc JT - Surgical endoscopy JID - 8806653 SB - IM MH - Humans MH - Retrospective Studies MH - *Cholestasis/etiology/surgery MH - Gastrostomy/adverse effects MH - Endosonography/adverse effects MH - *Biliary Tract Surgical Procedures/adverse effects MH - Cholangiopancreatography, Endoscopic Retrograde/adverse effects MH - Stents/adverse effects MH - Drainage/adverse effects OTO - NOTNLM OT - Biliary obstruction OT - Endoscopic ultrasound OT - Hepaticogastrostomy OT - Risk factor OT - Stent EDAT- 2022/06/11 06:00 MHDA- 2022/11/16 06:00 CRDT- 2022/06/10 00:03 PHST- 2022/01/10 00:00 [received] PHST- 2022/05/20 00:00 [accepted] PHST- 2022/06/11 06:00 [pubmed] PHST- 2022/11/16 06:00 [medline] PHST- 2022/06/10 00:03 [entrez] AID - 10.1007/s00464-022-09346-z [pii] AID - 10.1007/s00464-022-09346-z [doi] PST - ppublish SO - Surg Endosc. 2022 Dec;36(12):8950-8958. doi: 10.1007/s00464-022-09346-z. Epub 2022 Jun 9.