| セッション情報 |
International Session8(消化器内視鏡学会・消化器病学会合同)
Recent advances in Interventional EUS 《Video》
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| タイトル |
内IS8-6：EUS-guided hepaticogastrostomy (EUS-HGS):stent selection to reduce complications
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| 演者 |
Y. Nakai（Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo） |
| 共同演者 |
H. Isayama（Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo）, K. Koike（Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo） |
| 抄録 |
[AIM]Efficacy of EUS-HGS has been increasingly reported in malignant biliary obstruction, but lack of dedicated devices can cause complications. Though covered Self-expandable Metallic Stent(cSEMS) prevents bile leak, stent selection to reduce migration is still unclear. We investigated association of length in peritoneum or stomach with type of stent or dilation method.[Method]cSEMS length in peritoneum and stomach was evaluated in 14 EUS-HGS: 8-cm Covered Wallflex(CWX) 4, 12cm length Niti-S S-type (Niti-S) 5, 12-cm Supremo type 5. Dilation methods were electric cautery dilator/balloon/bougie in 11/6/6.[Results]Primary tumor was pancreas 6, stomach 3, bile duct 2, ampulla/duodenum 3. The reason for EUS-HGS was GOO 10, altered anatomy 4. Technical success rate was 100%, though 2 tandem stent placement was necessary in 1 case due to Supremo stent misplacement in peritoneum. Stent length of CWX/Niti-S/Supremo was 28.3/15.4/44.2mm in peritoneum, 27.3/60.0/46.8mm in stomach. Peritoneal stent length was long in Supremo, which expands per each cell. Peritoneal stent length was longer after balloon dilation:35.3 vs.24.9mm. Gastric stent length was short in CWX and two stent migration was observed in CWX on day 7 and 9.[Conclusion]Peritoneal stent length was associated with stent type or dilation method. Short stent length in stomach caused migration. To establish safety of EUS-HGS, development of dedicated cSEMS which does not expand per cell and can be easily inserted without balloon dilation is essential. |
| 索引用語 |
EUS, biliary drainage |
