Background Recently, antegrade procedures via the endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) have been developed as an alternative technique for failed ERCP. However, the time required for formation of endosonography-created route (ESCR) after EUS-HGS is still unknown. To prevent adverse event after stent removal, stent removal using the through mesh technique might be useful. The aim of this study was to evaluate the time to ESCR formation. Patients and Methods Consecutive patients who underwent EUS-HGS using self-expandable metal stent (SEMS) and EUS-HGS stent removal for performing antegrade procedures were retrospectively enrolled. The primary endpoint was evaluation of rate of ESCR formation. In the present study, EUS-HGS stent removal was attempted around 14 days. Results A total of 104 patients were enrolled in this study. EUS-HGS was performed using by partially covered SEMS (n=82) or fully covered SEMS (n=22). EUS-HGS stent removal was successfully performed in 102 patients (98.1%). The 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. The mean procedure time was 24.0 min. The rate of adverse events was 2.9% (3/104), all adverse events were successfully treated conservatively. Conclusions In conclusion, ESCR might have been established by a median of 13 days following EUS-HGS using SEMS, however, time to ESCR formation should be evaluated in further study.
Uba et al. (Fri,) studied this question.