Clinical Endoscopy

Case Report

Endoscopic ultrasound-guided hepaticogastrostomy by puncturing both B2 and B3: a single center experience: Moaz Elshair, Kazuo Hara, Nozomi Okuno, Shin Haba, Takamichi Kuwahara, Asmaa Bakr, Abdou Elshafei, Mohamed Z. Abu-Amer; Clin Endosc 2024;57(4):542-546. Published online May 3, 2023; DOI: https://doi.org/10.5946/ce.2022.209

Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) through ducts B2 or B3 is effective in most patients with biliary obstruction, because B2 and B3 commonly join together. However, in some patients, B2 and B3 do not join each other due to invasive hilar tumors; therefore, single-route drainage is insufficient. Here, we investigated the feasibility and efficacy of EUS-HGS through both B2 and B3 simultaneously in seven patients. We decided to perform EUS-HGS through both B2 and B3 to achieve adequate biliary drainage because these two ducts were separate from each other. Here, we report a 100% technical and overall clinical success rate. Early adverse effects were closely monitored. Minimal bleeding was reported in one patient (1/7) and mild peritonitis in one patient (1/7). None of the patients experienced stent dysfunction, fever, or bile leakage after the procedure. EUS-HGS through both B2 and B3 simultaneously is safe, feasible, and effective for biliary drainage in patients with separated ducts.

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A novel technique of B2–B3 single-puncture bridging through liver parenchyma enabling endoscopic ultrasound-guided hepaticogastrostomy for rescue drainage
Hiroki Koda, Kazuo Hara, Nozomi Okuno, Shin Haba, Takamichi Kuwahara, Shimpei Matsumoto, Tomoki Ogata
Endoscopy.2025; 57(S 01): E936. CrossRef

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Original Article

Utility of forward-view endoscopic ultrasound in fine-needle aspiration in patients with a surgically altered upper gastrointestinal anatomy: Asmaa Bakr, Kazuo Hara, Moaz Elshair, Shin Haba, Takamichi Kuwahara, Nozomi Okuno, Daiki Fumihara, Takafumi Yanaidani, Samy Zaky, Hanaa Omar; Clin Endosc 2023;56(3):367-374. Published online January 5, 2023; DOI: https://doi.org/10.5946/ce.2021.238

Graphical Abstract Abstract PDF

Background
/Aims: Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) using oblique-view EUS in patients with a surgically altered anatomy (SAA) of the upper gastrointestinal tract is limited because of difficult scope insertion due to the disturbed anatomy. This study aimed to investigate the efficiency of forward-view (FV)-EUS in performing FNA in patients with a SAA.
Methods
We retrospectively investigated 32 patients with a SAA of the upper gastrointestinal tract who visited Aichi Cancer Center Hospital in Nagoya, Japan, between January 2014 and December 2020. We performed-upper gastrointestinal EUS-FNA using FV-EUS combined with fluoroscopic imaging to confirm tumor recurrence or to make a decision before chemotherapy or after a failure of diagnosis by radiology.
Results
We successfully performed EUS-FNA in all studied patients (100% technical success), with the specificity, sensitivity, and accuracy of 100%, 87.5%, and 87.8%, respectively, with no complications.
Conclusions
EUS-FNA using FV-EUS combined with fluoroscopic imaging is an effective and safe technique for tissue acquisition in patients with a SAA.

Citations

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Endoscopic ultrasonography-guided vascular intervention for bile duct–jejunal anastomotic variceal bleeding
Takashi Kondo, Kazuo Hara, Nozomi Okuno, Shin Haba, Takamichi Kuwahara, Minako Urata, Yoshitaro Yamamoto
Endoscopy.2025; 57(S 01): E335. CrossRef
Role of the EUS in the Treatment of Biliopancreatic Disease in Patients with Surgically Altered Anatomy
Marcello Cintolo, Edoardo Forti, Giulia Bonato, Michele Puricelli, Lorenzo Dioscoridi, Marianna Bravo, Camilla Gallo, Francesco Pugliese, Andrea Palermo, Alessia La Mantia, Massimiliano Mutignani
Diagnostics.2025; 15(21): 2707. CrossRef

5,472 View
205 Download
2 Web of Science
2 Crossref

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