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Article Abstract
Background And Objectives: Recurrence of benign bilioenteric anastomotic strictures (BAS) is common after enteroscopy-assisted endoscopic retrograde cholangiopancreatography (ERCP), percutaneous intervention, or EUS-guided antegrade intervention (EUS-AI). This study evaluated the long-term outcomes of EUS-AI with transmural and transanastomotic stenting (TAS) following EUS-guided hepaticogastrostomy (HGS) in BAS.
Methods: Consecutive patients with BAS undergoing EUS-AI with or without TAS after failed deep enteroscopy between January 2016 and June 2023 were retrospectively analyzed. The primary outcome was BAS recurrence rate after TAS removal; secondary outcomes included technical success of AI, on demand endoscopic procedure (DP) rate, the time to DP, and adverse events.
Results: Among 38 patients who underwent EUS-HGS, EUS-AI succeeded in 34 (89.5%), and 28 (73.7%) proceeded to TAS. The median follow-up duration for 28 patients with TAS was 53.4 months (IQR, 22.8-85.2). During TAS placement without regular stent change, DP occurred in 43% (12/28) at a median time of 23 months. The 1-year procedure-free rate was 81.2%. After TAS removal ( = 12), with a median stent duration of 21.6 months, there was no BAS recurrence (0%).
Conclusion: EUS-AI with indwelling TAS, without regular stent change, may offer promising long-term outcomes for BAS by reducing recurrence.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080696 | PMC |
| http://dx.doi.org/10.1097/eus.0000000000000112 | DOI Listing |
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