Safety and efficacy of endoscopic ultrasound-guided hepaticogastrostomy for the treatment of hilar and distal biliary obstruction: a retrospective cohort study
10.3760/cma.j.cn321463-20221118-00127
- VernacularTitle:超声内镜引导下肝胃吻合术治疗肝门部与远端胆道梗阻的安全性与有效性分析：一项回顾性队列研究
- Author:
Peng YAN
1
;
Muhan NI
;
Yonghua SHEN
;
Rui MENG
;
Lei WANG
Author Information
1. 南京大学医学院附属鼓楼医院消化科，南京 210008
- Keywords:
Biliary tract;
Ultrasound-guided hepaticogastrostomy;
Obstruction;
Safety;
Efficacy
- From:
Chinese Journal of Digestive Endoscopy
2023;40(5):379-384
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the safety and efficacy of endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) for the treatment of biliary obstruction at different locations.Methods:From January 2016 to June 2021 data of 82 patients with obstructive jaundice treated with EUS-HGS in Nanjing Drum Tower Hospital were reviewed in this retrospective cohort study. According to the location of biliary obstruction,patients were divided into hilar biliary obstruction group ( n=30) and distal biliary obstruction group ( n=52). Univariate and multivariate logistic regression analyses were conducted adjusting covariates to compare the technical success rate, the clinical success rate, the adverse reaction incidence, hospital stay and cost of the two groups. Results:The technical success rates were 93.3% (28/30) and 94.2% (49/52) in the hilar biliary obstruction group and the distal biliary obstruction group with no significant difference between the two groups ( P=0.870, OR=1.17, 95% CI: 0.18-7.41). The clinical success rates were 83.3% (25/30) and 88.5% (46/52) in the hilar biliary obstruction group and the distal biliary obstruction group with no significant difference between the two groups ( P=0.514, OR=1.53, 95% CI: 0.43-5.53). The incidence of adverse events in hilar biliary obstruction group was 10.0% (3/30), including cholangitis 3.3% (1/30), biliary fistula 6.7% (2/30), biliary peritonitis 6.7% (2/30). The incidence of adverse events in patients with distal biliary obstruction was 17.3% (9/52), including cholangitis 9.6% (5/52), biliary fistula 7.7% (4/52) and biliary peritonitis 5.8% (3/52). There was no significant difference in the incidence of adverse events between the two groups ( P>0.05). Conclusion:There is no significant difference in safety or efficacy of EUS-HGS for hilar biliary obstruction and distal biliary obstruction.
