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The intra-conduit release method is useful for avoiding migration of metallic stents during EUS-guided hepaticogastrostomy (with video)

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Abstract

Purpose

Although EUS-guided hepaticogastrostomy (EUS-HGS) with a covered self-expandable metal stent (SEMS) is a useful procedure, it is associated with severe adverse events, including stent migration. We, therefore, developed an intra-conduit release method, and investigated whether the technique yields a safer and more stable procedure.

Methods

The intra-conduit release method is a procedure to release the SEMS in the working channel conduit of the scope for anchoring between the liver and stomach to avoid stent migration. Forty-three patients who underwent EUS-HGS at two high-volume centers in Japan were enrolled in this retrospective study, and the safety and usefulness of this method were evaluated retrospectively.

Results

The intra-conduit release method was applied in 36 cases. The technical success rate of EUS-HGS with the intra-conduit release method was significantly higher in comparison with the conventional method. Additionally, the rate of early adverse events was significantly lower than that for the conventional method.

Conclusion

The intra-conduit release method during EUS-HGS is useful for a stable procedure that avoids early adverse events.

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Author information

Authors and Affiliations

  1. Department of Gastroenterology, Okayama University Hospital, Okayama, Japan

    Daisuke Uchida, Hironari Kato, Takeshi Tomoda, Kazuyuki Matsumoto, Shigeru Horiguchi, Koichiro Tsutsumi & Hiroyuki Okada

  2. Department of General Internal Medicine 2, Kawasaki Hospital, Kawasaki Medical School, 2-6-1 Nakasange, Kita-ku, Okayama, Japan

    Hirofumi Kawamoto

  3. Department of Internal Medicine, Tottori Red Cross Hospital, Tottori, Japan

    Daisuke Goto

  4. Department of Gastroenterology, Shigei Medical Research Hospital, Okayama, Japan

    Naoki Yamamoto

Authors
  1. Daisuke Uchida
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  2. Hirofumi Kawamoto
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  3. Hironari Kato
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  4. Daisuke Goto
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  5. Takeshi Tomoda
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  6. Kazuyuki Matsumoto
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  7. Naoki Yamamoto
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  8. Shigeru Horiguchi
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  9. Koichiro Tsutsumi
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  10. Hiroyuki Okada
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Corresponding author

Correspondence to Hirofumi Kawamoto.

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Conflict of interest

Drs. Daisuke Uchida, Hirofumi Kawamoto, Hironari Kato, Daisuke Goto, Takeshi Tomoda, Kazuyuki Matsumoto, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, and Hiroyuki Okada have no conflicts of interest or financial ties to disclose.

Ethical statements

The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki, as reflected in its approval by the ethics committee at Okayama University Hospital and Kawasaki Hospital.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 Video 1 An animation demonstrating the mechanism of SEMS migration (MP4 27390 kb)

Supplementary material 2 Video 2 An animation demonstrating the intra-conduit release method (MP4 17500 kb)

Supplementary material 3 Video 3 A video demonstrating the intra-conduit release method (MP4 43559 kb)

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Cite this article

Uchida, D., Kawamoto, H., Kato, H. et al. The intra-conduit release method is useful for avoiding migration of metallic stents during EUS-guided hepaticogastrostomy (with video). J Med Ultrasonics 45, 399–403 (2018). https://doi.org/10.1007/s10396-017-0846-x

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  • DOI: https://doi.org/10.1007/s10396-017-0846-x

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