Clinical Endoscopy

Original Article

Endoscopic ultrasound-guided hepaticogastrostomy and endoscopic retrograde cholangiopancreatography-guided biliary drainage for distal malignant biliary obstruction due to pancreatic cancer with asymptomatic duodenal invasion: a retrospective, single-center study in Japan: Naminatsu Takahara, Yousuke Nakai, Kensaku Noguchi, Tatsunori Suzuki, Tatsuya Sato, Ryunosuke Hakuta, Kazunaga Ishigaki, Tomotaka Saito, Tsuyoshi Hamada, Mitsuhiro Fujishiro; Clin Endosc 2025;58(1):134-143. Published online August 23, 2024; DOI: https://doi.org/10.5946/ce.2024.031

Graphical Abstract Abstract PDF PubReader ePub

Background
/Aims: Duodenal invasion (DI) is a risk factor for early recurrent biliary obstruction (RBO) in endoscopic retrograde cholangiopancreatography-guided biliary drainage (ERCP-BD). Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) may reduce early RBO in cases of asymptomatic DI, even when ERCP is possible.
Methods
We enrolled 56 patients with pancreatic cancer and asymptomatic DI who underwent EUS-HGS (n=25) or ERCP-BD (n=31). Technical and clinical success, early (<3 months) and overall RBO rates, time to RBO (TRBO), and adverse events were compared between the EUS-HGS and ERCP-BD groups. Risk factors for early RBO were also evaluated.
Results
Baseline characteristics were similar between the groups. Both procedures demonstrated 100% technical and clinical success rates, with a similar incidence of adverse events (48% vs. 39%, p=0.59). While the median TRBO was comparable (5.7 vs. 8.8 months, p=0.60), EUS-HGS was associated with a lower incidence of early RBO compared to ERCP-BD (8% vs. 29%, p=0.09). The major causes of early RBO in ERCP-BD were sludge and food impaction, rarely occurring in EUS-HGS. EUS-HGS was potentially reduced early RBO (odds ratio, 0.32; p=0.07).
Conclusions
EUS-HGS can be a viable option for treating pancreatic cancer with asymptomatic DI.

Citations

Citations to this article as recorded by

Endoscopic Retrograde Cholangiopancreatography‐guided Biliary Drainage with Duckbill‐type Anti‐reflux Metal Stent versus Endoscopic Ultrasound‐guided Hepaticogastrostomy for Malignant Distal Biliary Obstruction in Pancreatic Cancer with Duodenal Invasion
Tsuyoshi Takeda, Takashi Sasaki, Tatsuki Hirai, Yoichiro Sato, Yuri Maegawa, Takafumi Mie, Takaaki Furukawa, Yukari Suzuki, Takeshi Okamoto, Masato Ozaka, Naoki Sasahira
DEN Open.2026;[Epub] CrossRef
Biliary drainage in pancreatic cancer with duodenal invasion: which route is the best?
Tanyaporn Chantarojanasiri, Thawee Ratanachu-Ek
Clinical Endoscopy.2025; 58(1): 82. CrossRef

2,445 View
309 Download
3 Web of Science
2 Crossref

Focused review series

Current Status of Endoscopic Ultrasound Techniques for Pancreatic Neoplasms: Yousuke Nakai, Naminatsu Takahara, Suguru Mizuno, Hirofumi Kogure, Kazuhiko Koike; Clin Endosc 2019;52(6):527-532. Published online July 24, 2019; DOI: https://doi.org/10.5946/ce.2019.025

Abstract PDF PubReader ePub

Endoscopic ultrasound (EUS) now plays an important role in the management of pancreatic neoplasms. There are various types of pancreatic neoplasms, from benign to malignant lesions, and the role of EUS ranges from the imaging diagnosis to treatment. EUS is useful for the detection, characterization, and tissue acquisition of pancreatic lesions. Recent advancement of contrast-enhanced harmonic EUS and elastography enables better characterization of pancreatic lesions. In addition to these enhanced EUS imaging techniques, EUS-guided tissue acquisition is now the standard procedure to establish the pathological diagnosis of pancreatic neoplasms. While these diagnostic roles of EUS have been established, EUS-guided interventions such as ablation and drainage are also increasingly utilized in the management of pancreatic neoplasms. However, most of these EUS-guided interventions are not yet standardized in terms of techniques and devices and thus need further investigations.

Citations

Citations to this article as recorded by

Advancements in the application of ablative therapy and its combination with immunotherapy in anti-cancer therapy
Lu-Hong Wang, Yi Jiang, Chen-Hang Sun, Peng-Tao Chen, Yi-Nan Ding
Biochimica et Biophysica Acta (BBA) - Reviews on Cancer.2025; 1880(2): 189285. CrossRef
Impact of endoscopic ultrasound-guided radiofrequency ablation in managing pancreatic malignancy
Cosmas Rinaldi Adithya Lesmana
World Journal of Gastrointestinal Surgery.2023; 15(2): 163. CrossRef
Artificial intelligence assisted endoscopic ultrasound for detection of pancreatic space occupying lesion: A systematic review and meta-analysis
Arkadeep Dhali, Vincent Kipkorir, Bahadar S. Srichawla, Harendra Kumar, Roger B. Rathna, Ibsen Ongidi, Talha Chaudhry, Gisore Morara, Khulud Nurani, Doreen Cheruto, Jyotirmoy Biswas, Leonard R. Chieng, Gopal Krishna Dhali
International Journal of Surgery.2023;[Epub] CrossRef
Endotherapy in Pancreatic Diseases
Vaneet Jearth, Surinder S. Rana
Journal of Digestive Endoscopy.2022; 13(01): 019. CrossRef
Endoscopic Management of Pancreatobiliary Malignancies
Dong Wook Lee, Eun Young Kim
Digestive Diseases and Sciences.2022; 67(5): 1635. CrossRef
Bazo accesorio intrapancreático: reporte de caso resuelto con pancreatectomía distal robótica
Armando Pereyra-Talamantes, Juan Eduardo Flores-Martín, Marco Antonio Gallaga-Rojas, Jesús Emmanuel Rodríguez-Silverio, Erikc González-Azua, Mario Eduardo Alonso-Calamaco, Enrique Jiménez-Chavarría, Héctor F Noyola-Villalobos
Revista Mexicana de Cirugía Endoscópica.2022; 23(1-2): 41. CrossRef
Dynamic Doppler Ultrasound Assessment of Tissue Perfusion Is a Better Tool than a Single Vessel Doppler Examination in Differentiating Malignant and Inflammatory Pancreatic Lesions
Przemysław Dyrla, Arkadiusz Lubas, Jerzy Gil, Marek Saracyn, Maciej Gonciarz
Diagnostics.2021; 11(12): 2289. CrossRef
Differential diagnosis of solid pancreatic masses
Julio Iglesias-Garcia, Daniel de la Iglesia-Garcia, José M. Olmos-Martinez, José Lariño-Noia, J. Enrique Dominguez-Muñoz
Minerva Gastroenterologica e Dietologica.2020;[Epub] CrossRef

6,732 View
251 Download
7 Web of Science
8 Crossref

First
Prev
Page of 1
Next
Last

Search