PMID- 38382887
OWN - NLM
STAT- Publisher
LR  - 20240221
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
DP  - 2024 Feb 19
TI  - Endoscopic ultrasound-guided hepaticogastrostomy versus hepaticogastrostomy with 
      antegrade stenting in patients with unresectable malignant distal biliary 
      obstruction: a propensity score-matched case-control study.
LID - S0016-5107(24)00109-3 [pii]
LID - 10.1016/j.gie.2024.02.012 [doi]
AB  - BACKGROUND AND AIMS: Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) 
      is a rescue procedure when endoscopic retrograde cholangiopancreatography fails. 
      Peritonitis and recurrent biliary obstruction (RBO) are adverse events (AEs) 
      associated with EUS-HGS. Antegrade stenting across a malignant distal biliary 
      obstruction (MDBO) followed by EUS-HGS (EUS-HGAS) creates two biliary drainage 
      routes, potentially reducing peritonitis and prolonging time to RBO (TRBO). We 
      compared the outcomes of the two techniques. METHODS: Data of consecutive 
      patients with MDBO who underwent attempted EUS-HGS or EUS-HGAS across five 
      institutions from January 2014 to December 2020 were retrospectively analyzed. A 
      matched cohort of the patients was obtained using one-to-one propensity score 
      matching. The primary outcome was TRBO, and secondary outcomes included AEs 
      except for RBO and overall survival (OS). RESULTS: Among 360 patients, 283 (176 
      and 107 in the HGS and HGAS groups, respectively) were eligible. The matched 
      cohorts included 81 patients in each group. AEs developed in 10 (12.3%) and 15 
      (18.5%) patients (p=0.38) in the HGS and HGAS groups, respectively. RBO occurred 
      in 18 and 2 patients in the HGS and HGAS groups, respectively (p<0.001). TRBO was 
      significantly longer in the HGAS group (median 194 vs. 716 days; hazard ratio 
      [HR]=0.050, 95% confidence interval [CI]=0.0066-0.37, p<0.01). However, there was 
      no significant difference in OS between the groups (median 97 vs. 112 days; 
      HR=0.97, 95% CI=0.66-1.4, p=0.88). CONCLUSIONS: EUS-HGAS extended TRBO compared 
      with EUS-HGS, while AEs, except for RBO and OS, did not differ. The longer TRBO 
      of EUS-HGAS could benefit patients with longer life expectancy.
CI  - Copyright (c) 2024 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Ishiwatari, Hirotoshi
AU  - Ishiwatari H
AD  - Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan. Electronic 
      address: ishihiro481019@gmail.com.
FAU - Ogura, Takeshi
AU  - Ogura T
AD  - Endoscopy Center, Osaka Medical and Pharmaceutical University, Osaka, Japan.
FAU - Hijioka, Susumu
AU  - Hijioka S
AD  - Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center 
      Hospital, Tokyo, Japan.
FAU - Iwashita, Takuji
AU  - Iwashita T
AD  - First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan.
FAU - Matsubara, Saburo
AU  - Matsubara S
AD  - Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama 
      Medical University, Saitama, Japan.
FAU - Ishikawa, Kazuma
AU  - Ishikawa K
AD  - Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan.
FAU - Niiya, Fumitaka
AU  - Niiya F
AD  - Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan.
FAU - Sato, Junya
AU  - Sato J
AD  - Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan.
FAU - Okuda, Atsushi
AU  - Okuda A
AD  - Second Department of Internal Medicine, Osaka Medical and Pharmaceutical 
      University, Osaka, Japan.
FAU - Ueno, Saori
AU  - Ueno S
AD  - Second Department of Internal Medicine, Osaka Medical and Pharmaceutical 
      University, Osaka, Japan.
FAU - Nagashio, Yoshikuni
AU  - Nagashio Y
AD  - Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center 
      Hospital, Tokyo, Japan.
FAU - Maruki, Yuta
AU  - Maruki Y
AD  - Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center 
      Hospital, Tokyo, Japan.
FAU - Uemura, Shinya
AU  - Uemura S
AD  - First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan.
FAU - Notsu, Akifumi
AU  - Notsu A
AD  - Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan.
LA  - eng
PT  - Journal Article
DEP - 20240219
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
OTO - NOTNLM
OT  - antegrade stenting
OT  - endoscopic ultrasound-guided biliary drainage
OT  - hepaticogastrostomy
OT  - malignant distal biliary obstruction
OT  - pancreatic cancer
EDAT- 2024/02/22 00:43
MHDA- 2024/02/22 00:43
CRDT- 2024/02/21 19:19
PHST- 2023/08/20 00:00 [received]
PHST- 2024/02/10 00:00 [revised]
PHST- 2024/02/15 00:00 [accepted]
PHST- 2024/02/22 00:43 [medline]
PHST- 2024/02/22 00:43 [pubmed]
PHST- 2024/02/21 19:19 [entrez]
AID - S0016-5107(24)00109-3 [pii]
AID - 10.1016/j.gie.2024.02.012 [doi]
PST - aheadofprint
SO  - Gastrointest Endosc. 2024 Feb 19:S0016-5107(24)00109-3. doi: 
      10.1016/j.gie.2024.02.012.