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Relief of jaundice in malignant biliary obstruction:When should we consider endoscopic ultrasonography-guided hepaticogastrostomy as an option?

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Hepatobiliary & Pancreatic Diseases International 2022年第3期21卷 234-240页

作者： Alessandro Fugazza Matteo Colombo Marco Spadaccini Edoardo Vespa Roberto Gabbiadini Antonio Capogreco Alessandro Repici Andrea Anderloni Division of Gastroenterology and Digestive Endoscopy Humanitas Research Hospital-IRCCSMilanItaly Department of Biomedical Sciences Humanitas UniversityMilanItaly

Background:Since it was first described in 2001,endoscopic ultrasonography-guided biliary drainage(eus-BD)has emerged as an alternative procedure for achieving an endoscopic internal drainage in case of endoscopic retrograde cholangiopancreatography(ERCP)*** drainage can be achieved by either a transduodenal extrahepatic approach through eus-guided choledochoduodenostomy(eus-CDS),or a transgastric intrahepatic approach,namely eus-guided hepaticogastrostomy(eus-HGS)which already holds a remarkable place in the treatment of patients with malignant biliary *** sources:For this review we did a comprehensive search of PubMed/MEDLINE from inception to May 31,2021 for papers with a significant sample size(at least 20 patients enrolled)dealing with *** on technical success,clinical success and rate of adverse events were ***:A total of 22 studies with different design,com prising 874 patients,were *** success was achieved in about 96% of cases(ranging from 65% to 100%).Clinical success was obtained in almost 91% of cases(ranging from 76% to 100%).Overall rate of adverse events was 19%(ranging from 0% to 35%).Abdominal pain,self-limiting pneumoperitoneum,bile leak,cholangitis,bleeding,perforation and intraperitoneal migration of the stent were the most ***:Despite both safety and efficacy profile,at the moment HGS still remains a challenging procedure at every single step and must therefore be conducted by a very experienced endoscopist in interventional eus and ERCP procedures,who is able to deal with the possible severe adverse events of this procedure.A rapid introduction in clinical practice of dedicated devices is desiderable.

关键词： eus-guided hepaticogastrostomy eus-guided biliary drainage Hepaticogastrostomy Interventional eus

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