EUS-guided hepaticojejunostomy in patients with history of total gastrectomy: a multicenter retrospective feasibility study (with video).

Détails

ID Serval
serval:BIB_E05C6AA23492
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
EUS-guided hepaticojejunostomy in patients with history of total gastrectomy: a multicenter retrospective feasibility study (with video).
Périodique
Gastrointestinal endoscopy
Auteur⸱e⸱s
Balducci D., Ratone J.P., Schaefer M., Godat S., Perez-Cuadrado-Robles E., Hoibian S., Dahel Y., Dalex M., Chevaux J.B., Caillol F., Giovannini M.
ISSN
1097-6779 (Electronic)
ISSN-L
0016-5107
Statut éditorial
Publié
Date de publication
01/2025
Peer-reviewed
Oui
Volume
101
Numéro
1
Pages
117-122
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study ; Video-Audio Media
Publication Status: ppublish
Résumé
EUS-guided hepaticogastrostomy (EUS-HGS) is an effective biliary drainage technique for patients with altered anatomy or duodenal strictures. EUS-guided hepaticojejunostomy (EUS-HJS) can be used to create a fistula between the left hepatic duct and the jejunum in patients with a history of total gastrectomy. No specific data on this technique have been published. The aim of this study was to assess the feasibility and safety of EUS-HJS in patients with a history of total gastrectomy.
This retrospective multicenter study included all adult patients who underwent EUS-HJS at 3 tertiary French centers and 1 tertiary Swiss center between May 2011 and February 2023. The primary outcome was clinical success, which was defined as the disappearance of pruritus, jaundice, and/or cholangitis. An improvement in bilirubin >30% within the first week and/or bilirubin normalization within 1 month after the procedure were also considered indicators of clinical success. Secondary outcomes were technical success, rate of adverse events, need for endoscopic revision, possibility of resuming anticancer treatment, median survival, and technical differences compared with EUS-HGS.
Twenty-one patients with history of complete gastrectomy who underwent EUS-HJS were included. Technical success was achieved in 100% of patients (95% confidence interval [CI], 85-100). Clinical success was achieved in 80% of patients (95% CI, 58-92). The incidence of recorded adverse events was 33% (95% CI, 17-55), with cholangitis being the most frequent adverse event. Seven patients (39%) were able to benefit from anticancer treatment after the procedure. Median survival time was 6 months (interquartile range, 1.5-12).
EUS-HJS is an effective and feasible procedure for patients whose anatomy has been altered by total gastrectomy.
Mots-clé
Humans, Retrospective Studies, Feasibility Studies, Male, Female, Gastrectomy/methods, Aged, Middle Aged, Endosonography, Stomach Neoplasms/surgery, Drainage/methods, Jejunostomy/methods, Hepatic Duct, Common/surgery, Aged, 80 and over, Ultrasonography, Interventional, Cholangitis/surgery, Jejunum/surgery, Surgery, Computer-Assisted/methods, Treatment Outcome
Pubmed
Web of science
Création de la notice
26/07/2024 14:10
Dernière modification de la notice
21/01/2025 8:10
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