ESGE Days 2025 - oral presentations | EUS-guided anastomosis: Let's get connected again I Episode 4
EUS-guided Hepaticogastrostomy using a novel dedicated partially covered stent in Patients with Malignant Biliary Obstruction (EPSILON); a prospective cohort study
COURSE
Series: ESGE Days 2025 - oral presentations
Season: EUS-guided anastomosis: Let's get connected again
Episode 4 of 5: EUS-guided Hepaticogastrostomy using a novel dedicated partially covered stent in Patients with Malignant Biliary Obstruction (EPSILON); a prospective cohort study
SPEAKERS
-
DESCRIPTION
The study presented assesses the safety and feasibility of endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) using a dedicated partially covered stent with anti-migration flaps (Giobor stent) for patients with inoperable malignant biliary obstructions. Conducted as a prospective single-center study, it included patients with duodenal obstruction, altered anatomy, or failed drainage of the left hepatic duct. The procedure was technically successful in most cases, with minimal serious adverse events. Some patients required re-intervention due to cholangitis or stent migration, but these issues were successfully managed endoscopically. Clinical success was achieved in nearly all cases with follow-up. The findings suggest that EUS-HGS with this specialized stent offers a safe and effective option for biliary drainage, reducing risks associated with conventional techniques.
LEARNING OBJECTIVES
EUS-guided Hepaticogastrostomy
RELATED DOCUMENTS
What to watch next...
ESGE Days 2025 - oral presentations | EUS-guided anastomosis: Let's get connected again | Episode 5
EUS guided Hepaticogastrostomy versus ERCP and SEMS placement within SEMS as reintervention in patients with blocked biliary metal endoprosthesis (00:10:35)
Description
This study compares endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) with stent-within-stent (SWS) placement as a reintervention for blocked biliary metal endoprostheses in patients with pancreaticobiliary malignancies. A retrospective review analyzed cases where either technique was used, with technical success achieved in all procedures and no major complications reported. While EUS-HGS showed slightly better functional success, the need for reintervention, reintervention-free survival, and overall survival were similar between both approaches. The findings indicate that EUS-HGS does not offer a clear advantage over SWS for managing blocked biliary stents.
Recommendations:
ESGE Days 2025 - oral presentations | EUS-guided anastomosis: Let's get connected again | Episode 3
Standardizing EUS-guided Gastroenterostomy: a Delphi consensus on technical steps and adverse events management (00:09:21)
Description
Dr Vanella presents a study for whicht the Delphi methodology was used in order to establish expert consensus on key aspects of EUS-guided gastroenterostomy (EUS-GE), a procedure increasingly used for managing gastric outlet obstruction. A panel of 25 international experts reviewed literature and participated in three rounds of predefined statements related to technique, safety, and procedural preferences. Strong agreement was reached on the use of fluoroscopy, electrocautery-enhanced lumen-apposing metal stents (LAMS), free-hand LAMS release, patient positioning, sedation, and saline solution for jejunal distention. Moderate agreement emerged on aspects like catheter-assisted EUS-GE and procedural space requirements, while statements regarding contrast use and technique preferences were ultimately removed due to a lack of consensus. The findings highlight key technical principles for standardizing EUS-GE while identifying areas that require further research.
ESGE Days 2025 - oral presentations | EUS-guided anastomosis: Let's get connected again | Episode 5
EUS guided Hepaticogastrostomy versus ERCP and SEMS placement within SEMS as reintervention in patients with blocked biliary metal endoprosthesis (00:10:35)
Description
This study compares endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) with stent-within-stent (SWS) placement as a reintervention for blocked biliary metal endoprostheses in patients with pancreaticobiliary malignancies. A retrospective review analyzed cases where either technique was used, with technical success achieved in all procedures and no major complications reported. While EUS-HGS showed slightly better functional success, the need for reintervention, reintervention-free survival, and overall survival were similar between both approaches. The findings indicate that EUS-HGS does not offer a clear advantage over SWS for managing blocked biliary stents.
