PMID- 36537386
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230427
IS  - 2303-9027 (Print)
IS  - 2226-7190 (Electronic)
IS  - 2226-7190 (Linking)
VI  - 11
IP  - 6
DP  - 2022 Nov-Dec
TI  - Efficacy of EUS-guided hepaticogastrostomy in prolonging survival of patients 
      with perihilar cholangiocarcinoma.
PG  - 487-494
LID - 10.4103/EUS-D-22-00014 [doi]
AB  - BACKGROUND AND OBJECTIVES: The background of this study was to evaluate the 
      outcomes of perihilar cholangiocarcinoma (pCCA) patients treated with EUS-guided 
      hepaticogastrostomy (EUS-HGS). METHODS: All patients with pCCA who underwent 
      EUS-HGS from 2010 to 2020 were analyzed. The primary outcome was clinical 
      success; the secondary outcomes were technical success, adverse events (AEs), 
      stent patency, and oncological outcomes. Cox proportional-hazards regression and 
      Kaplan-Meier curves were analyzed to identify variables related to survival. 
      RESULTS: Thirty-four patients (50% females, 76 years old) were included; 24 
      (70.6%) presented with distant metastasis. Indications for EUS-HGS were ERCP 
      failure (64.7%), duodenal stricture (23.5%), postsurgical anatomy (5.9%), and 
      dilation limited to the left intrahepatic duct (5.9%). The technical success rate 
      was 97.1%. The clinical success rate was 64.7%. Nine (26.5%) presented AEs, 2 
      fatal (bleeding and leakage). The overall survival was 91 (31-263) days. On 
      multivariate analysis, EUS-HGS clinical success (Exp[b]: 0.23 [0.09-0.60]; P = 
      0.003) and chemotherapy (Exp[b]: 0.06 [0.02-0.23]; P < 0.001) were significantly 
      associated with survival. The survival was longer in patients who achieved 
      EUS-HGS clinical success (178[61-393] vs. 15[73-24] days; hazard ratio: 6.3; P < 
      0.001) and in those starting chemotherapy (324[178-439] vs. 31 [9-48]; hazard 
      ratio: 1.2; P < 0.001). CONCLUSIONS: EUS-HGS is effective in pCCA patients 
      despite a not negligible AE rate. Clinical success, potentially leading to 
      jaundice resolution and chemotherapy start, significantly improves survival.
FAU - Schoch, Armelle
AU  - Schoch A
AD  - Endoscopic Department, Jean Mermoz Private Hospital, Lyon, France.
FAU - Lisotti, Andrea
AU  - Lisotti A
AD  - Endoscopic Department, Jean Mermoz Private Hospital, Lyon, France; Hospital of 
      Imola, University of Bologna, Italy.
FAU - Walter, Thomas
AU  - Walter T
AD  - Department of Medical Oncology, Edoard Herriot Hospital, Lyon, France.
FAU - Fumex, Fabien
AU  - Fumex F
AD  - Endoscopic Department, Jean Mermoz Private Hospital, Lyon, France.
FAU - Leblanc, Sarah
AU  - Leblanc S
AD  - Endoscopic Department, Jean Mermoz Private Hospital, Lyon, France.
FAU - Artru, Pascal
AU  - Artru P
AD  - Endoscopic Department, Jean Mermoz Private Hospital, Lyon, France.
FAU - Desrame, Jerome
AU  - Desrame J
AD  - Endoscopic Department, Jean Mermoz Private Hospital, Lyon, France.
FAU - Brighi, Nicole
AU  - Brighi N
AD  - Department of Medical Oncology, IRCCS Institute for the Study of Cancer (IRST) 
      "Dino Amadori", Meldola, Italy.
FAU - Marsot, Julien
AU  - Marsot J
AD  - Department of Radiology, Jean Mermoz Private Hospital, Lyon, France.
FAU - Souquet, Jean-Christophe
AU  - Souquet JC
AD  - Department of Gastroenterology, Croix-Rousse Hospital, Lyon, France.
FAU - Napoleon, Bertrand
AU  - Napoleon B
AD  - Endoscopic Department, Jean Mermoz Private Hospital, Lyon, France.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Endosc Ultrasound
JT  - Endoscopic ultrasound
JID - 101622292
PMC - PMC9921975
OTO - NOTNLM
OT  - Cholangitis
OT  - Klatskin
OT  - guidelines
OT  - jaundice
OT  - malignant biliary obstruction
COIS- None
EDAT- 2022/12/21 06:00
MHDA- 2022/12/21 06:01
PMCR- 2022/12/05
CRDT- 2022/12/20 06:14
PHST- 2022/12/20 06:14 [entrez]
PHST- 2022/12/21 06:00 [pubmed]
PHST- 2022/12/21 06:01 [medline]
PHST- 2022/12/05 00:00 [pmc-release]
AID - EndoscUltrasound_2022_11_6_487_362820 [pii]
AID - EUS-11-487 [pii]
AID - 10.4103/EUS-D-22-00014 [doi]
PST - ppublish
SO  - Endosc Ultrasound. 2022 Nov-Dec;11(6):487-494. doi: 10.4103/EUS-D-22-00014.