Evaluation of time to endosonographic creation route after endoscopic ultrasound-guided hepaticogastrostomy

Yuki Uba; Takeshi Ogura; Saori Ueno; Atsushi Okuda; Nobu Nishioka; Jun Sakamoto; Jun Matsuno; Mitsuki Tomita; Nobuhiro Hattori; Junichi Nakamura; Takafumi Kanadani; Kimi Bessho; Naoto Aoyama; Kouji Kawakami; Ahmad Fikry Aboelezz; Hiroki Nishikawa

doi:10.1055/a-2817-1109

Evaluation of time to endosonographic creation route after endoscopic ultrasound-guided hepaticogastrostomy

Endosc Int Open. 2026 Mar 16:14:a28171109. doi: 10.1055/a-2817-1109. eCollection 2026.

Authors

Affiliations

¹ 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.
² 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Japan.
³ 2nd Department of Internal Medicine, Osaka Medical College, Takatsuki-shi, Japan.
⁴ Internal medicine, Tanta University, Tanta, Egypt.

Abstract

Background and study aims: Recently, antegrade procedures via the endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) have been developed as an alternative technique for failed endoscopic retrograde cholangiopancreatography However, time required for formation of endosonography-created route (ESCR) after EUS-HGS is still unknown. To prevent adverse events (AEs) after stent removal, stent removal using the through mesh technique might be useful. The aim of this study was to evaluate time to ESCR formation.

Patients and methods: Consecutive patients who underwent EUS-HGS using self-expandable metal stents (SEMSs) and EUS-HGS stent removal for performing antegrade procedures were retrospectively enrolled. The primary endpoint was evaluation of the rate of ESCR formation. In the present study, EUS-HGS stent removal was attempted at approximately 14 days.

Results: A total of 104 patients were enrolled in this study. EUS-HGS was performed using by partially covered SEMSs (n = 82) or fully covered SEMSs (n = 22). EUS-HGS stent removal was successfully performed in 102 patients (98.1%). Median interval prior to EUS-HGS stent removal in the study subjects was 13 days (range 12-14 days). Among patients who underwent EUS-HGS stent removal, ESCR formation was confirmed in all cases. Mean procedure time was 24.0 minutes. The rate of AEs was 2.9% (3/104)and all AEs were successfully treated conservatively.

Conclusions: In conclusion, ESCR may have been established by a median of 13 days following EUS-HGS using SEMS; however, time to ESCR formation should be evaluated in a future study.

Keywords: Biliary tract; Endoscopic ultrasonography; Intervention EUS.

The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).