Clin Endosc.  2024 Jul;57(4):527-533. 10.5946/ce.2023.129.

Safety and efficacy of novel oblique-viewing scope for B2-endoscopic ultrasound-guided hepaticogastrostomy

• Ishikawa S
• Hara K
• Okuno N
• Mizuno N
• Haba S
• Kuwahara T
• Kuraishi Y
• Yanaidani T
• Yamada M
• Yasuda T
• Fukui T
• Kumagi T
• Hiasa Y

• KMID: 2558110
• DOI: http://doi.org/10.5946/ce.2023.129

Abstract

Background/Aims
Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (EUS-HGS) performed at the intrahepatic bile duct segment 3 (B3) is widely used for biliary drainage. Although performing post-puncture procedures is easier in the intrahepatic bile duct segment 2 (B2) when using a conventional oblique-viewing (OV) EUS scope, this method may cause transesophageal puncture and severe adverse events. We evaluated the safety and efficacy of B2 puncture using a novel OV-EUS scope.
Methods
In this single-center retrospective study, we prospectively enrolled and collected data from 45 patients who consecutively underwent EUS-HGS procedures with a novel OV-EUS scope between September 2021 and December 2022 at our cancer center.
Results
The technical success rates of B2-EUS-HGS and EUS-HGS were 93.3% (42/45) and 97.8% (44/45), respectively. The early adverse event rate was 8.9% (4/45) with no cases of scope changes or transesophageal punctures. The median procedure time was 13 minutes (range, 5–30).
Conclusions
B2-EUS-HGS can be performed safely with the novel EG-740UT (Fujifilm) OV-scope without transesophageal puncture and with a high success rate. B2-EUS-HGS using this novel OV scope may be the preferred strategy for EUS-HGS.

Keyword

Bile ducts; Endoscopy; Gastrostomy; Punctures; Ultrasound

Figure

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  Fig. 1. Flowchart of patient selection. B2, bile duct segment 2; EUS-HGS, endoscopic ultrasound-guided hepaticogastrostomy; OV, oblique-viewing.

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  Fig. 2. Comparison of EG-740UT (Fujifilm) and GF-UCT260 (Olympus) scopes. (A) Full-up angulations of EG-740UT (front) and GF-UCT260 (back). (B) Full-up angulation without the use of the EG-740UT and GF-UCT260 elevators with a 22-G fine needle aspiration (FNA) needle. (C) Full-up angulation and maximum elevation of the EG-740UT and GF-UCT260 elevators using a 22-G FNA needle.

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  Fig. 3. Comparison of EG-740UT (Fujifilm) and GF-UCT260 (Olympus) scopes using EUS images. (A) Without using the EG-740UT elevator. (B) With maximum elevation of the EG-740UT elevator. (C) Without using the GF-UCT260 elevator. (D) With maximum elevation of the GF-UCT260 elevator. EUS, endoscopic ultrasound.

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