Clinical Endoscopy

Original Articles

Percutaneous endoscopic gastrostomy with jejunal extension versus direct percutaneous endoscopic jejunostomy: patient-related outcomes and complications: Giel J.L. van Neerven, Eline H.T. Gilissen, Roos Gielen, Arlinda Baars, Bianca M.L. Stelten, Hajo Flink, Lennard P.L. Gilissen; Received October 28, 2025 Accepted January 8, 2026 Published online June 10, 2026; DOI: https://doi.org/10.5946/ce.2025.401 [Epub ahead of print]

Graphical Abstract Abstract PDF Supplementary Material PubReader ePub: Background
/Aims: Percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) and direct percutaneous endoscopic jejunostomy (D-PEJ) are used for jejunal feeding or administration of levodopa-carbidopa intestinal gel in patients with Parkinson’s disease. PEG-J is currently preferred because it is technically less challenging to insert. However, comparative studies are scarce, and data on patient-reported outcomes (PROMs) are limited.
Methods
In this retrospective study conducted at a referral hospital, clinical experience, adverse events (AEs), and PROMs associated with both techniques were evaluated.
Results
Ninety-three patients underwent PEG-J and/or D-PEJ placement between January 1, 2010, and July 1, 2022. Patients with PEG-J required significantly more re-endoscopies per tube-year than those with D-PEJ (0.63 [standard deviation, SD, 0.72] vs. 0.27 [SD 0.50]). A total of 76.8% of PEG-J patients underwent at least one re-endoscopy (range, 0–3.85 per year), primarily due to dislocated jejunal extensions (77.4%). Tube-related AEs (including dislocation, occlusion, perforation, and ulceration) occurred significantly more often after PEG-J insertion (76.7% vs. 25.9%). Forty-five patients (48%) completed the PROM questionnaire. No statistically significant differences were found in quality of life. However, D-PEJ patients reported significantly more tube-related pain (44.4% vs. 15.9%).
Conclusions
D-PEJ represents a viable alternative to PEG-J in experienced centers and should be considered when frequent complications with jejunal extensions occur.

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Efficacy of primary endoscopic ultrasound-guided biliary drainage with the placement of multiple plastic stents in the management of hepaticojejunostomy stricture: a retrospective, single-center study in Japan: Mako Ushio, Toshio Fujisawa, Ko Tomishima, Yusuke Takasaki, Shigeto Ishii, Koichi Ito, Akinori Suzuki, Daisuke Namima, Sho Takahashi, Taito Fukuma, Hiroto Ota, Daishi Kabemura, Muneo Ikemura, Ippei Ikoma, Yasuhisa Jimbo, Haruka Hagiwara, Yusuke Yamaguchi, Takumi Okuaki, Shin Arii, Hiroyuki Isayama; Clin Endosc 2025;58(6):909-917. Published online November 6, 2025; DOI: https://doi.org/10.5946/ce.2025.006

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Background
/Aims: Hepaticojejunostomy strictures (HJSS), recurrent cholangitis, and jaundice are major complications of surgical hepaticojejunostomy. Previously, HJSS was managed using percutaneous procedures and balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography. However, endoscopic ultrasound-biliary drainage (EUS-BD) was recently reported to be an effective salvage procedure. EUS-BD as a primary drainage method using a trans-endosonographically created route (trans-ESCR) has not been previously evaluated.
Methods
We enrolled consecutive patients who underwent EUS-BD for HJSS at the Juntendo University Hospital between March 2017 and December 2022. After ESCR maturation, multiple plastic stents were placed for 1 year with or without cholangioscopic evaluation. We evaluated the technical and clinical success rates, stent removal, HJSS recurrence, and related adverse events.
Results
Thirty-seven patients required EUS-guided hepaticogastrostomy/hepaticojejunostomy (n=36/1). The technical and clinical success rates were 94.6% and 100.0%, respectively, and 17% of patients experienced adverse events. Cholangioscopy via ESCR was performed in 19 patients to evaluate the strictures and manage concomitant stones. The success rate of stent removal after multiple stent placements for more than 1 year was 83%.
Conclusions
Primary EUS-BD and trans-ESCR are feasible and effective in the management of HJSS. Further prospective studies are needed to confirm the results of this pilot study.

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Endoscopic Technology for Diagnosis of Biliary Stricture with a Focus on Peroral Cholangioscopy: Challenges in Peroral Cholangioscopy-Based Management
Ko Tomishima, Hiroyuki Isayama, Toshio Fujisawa, Yusuke Takasaki, Taito Fukuma, Sho Takahashi, Shigeto Ishii
The Korean Journal of Pancreas and Biliary Tract.2026; 31(2): 42. CrossRef

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Predictors of failure of percutaneous endoscopic gastrostomy tube placement: a retrospective study in a tertiary care center in the USA: Ryan Xin, Cassandra Sanossian, Melissa Fazzari, Brandon Mui, Marouf Hossain, Jennifer Katz; Clin Endosc 2025;58(3):418-424. Published online January 23, 2025; DOI: https://doi.org/10.5946/ce.2024.118

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: Percutaneous endoscopic gastrostomy (PEG) tube placement is a common procedure used to initiate enteral feeding. To our knowledge, there are no previous studies that analyze predictors of PEG failure. This study aims to identify risk factors for failure of inpatient PEG placement.
Methods
A retrospective chart review was conducted of inpatients in the Montefiore Health System who were scheduled to undergo PEG placement from 2016 to 2020 (n=1,138). Patient, endoscopist, and procedural characteristics were summarized using descriptive statistics, both overall and stratified by whether the PEG was successfully placed.
Results
The overall success rate of PEG placement was 89%. The most common indications included stroke (31%), dementia (27%), and ventilator use (24%). Patient characteristics, including body mass index (BMI) (p=0.16) and indication for PEG placement (p=0.06), were not significantly associated with PEG failure. Instead, endoscopist and procedural characteristics were found to be significant, including type of attending (p<0.001), location of case (p=0.02), and category of anesthesia (p<0.001).
Conclusions
PEG placement remains a highly successful procedure. Endoscopist and procedural characteristics, not patient characteristics, were associated with PEG placement success. Notably, patient BMI and indication for PEG placement could not be used to risk stratify candidates for PEG placement.

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Efficacy and safety of endoscopic ultrasound-guided hepaticogastrostomy for biliary drainage in hypervascular hepatocellular carcinoma: a retrospective study from Japan: Kenneth Tachi, Kazuo Hara, Nozomi Okuno, Shin Haba, Takamichi Kuwahara, Toshitaka Fukui, Ahmed Mohammed Sadek, Hossam El-Din Shaaban Mahmoud Ibrahim, Minako Urata, Takashi Kondo, Yoshitaro Yamamoto; Clin Endosc 2025;58(3):448-456. Published online November 11, 2024; DOI: https://doi.org/10.5946/ce.2024.079

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: Biliary obstruction drainage in patients with hepatocellular carcinoma (HCC) is associated with symptom palliation, improved access to chemotherapy, and improved survival. Stent placement and exchange via endoscopic retrograde cholangiopancreatography biliary drainage risk traversing the HCC, a hypervascular tumor and causing bleeding. Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) potentially prevents procedure-related bleeding. Therefore, we evaluated the efficacy and safety of EUS-HGS as an alternative treatment for biliary obstruction in patients with HCC.
Methods
This was a retrospective study of all EUS-HGS procedures performed in patients with HCC at the Aichi Cancer Center Hospital, Japan, from February 2017 to August 2023.
Results
A total of 14 EUS-HGS procedures (42.9% primary) were attempted in 10 HCC patients (mean age 71.5 years, 80.0% male). Clinical and technical success rates were 92.9% and 90.9%, respectively. The observed procedure details in the 13 successful procedures included B3 puncture (53.8%), 22-G needle (53.8%), fully covered self-expandable metal stent (100%), and mean procedure time (32.7 minutes). There was no bleeding. Mild complications occurred in 27.3%. All patients resumed oral intake within 24 hours.
Conclusions
EUS-HGS is a technically feasible and clinically effective initial or salvage drainage option for the treatment of biliary obstruction in patients with HCC.

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Endoscopic ultrasound-guided hepaticogastrostomy and endoscopic retrograde cholangiopancreatography-guided biliary drainage for distal malignant biliary obstruction due to pancreatic cancer with asymptomatic duodenal invasion: a retrospective, single-center study in Japan: Naminatsu Takahara, Yousuke Nakai, Kensaku Noguchi, Tatsunori Suzuki, Tatsuya Sato, Ryunosuke Hakuta, Kazunaga Ishigaki, Tomotaka Saito, Tsuyoshi Hamada, Mitsuhiro Fujishiro; Clin Endosc 2025;58(1):134-143. Published online August 23, 2024; DOI: https://doi.org/10.5946/ce.2024.031

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Background
/Aims: Duodenal invasion (DI) is a risk factor for early recurrent biliary obstruction (RBO) in endoscopic retrograde cholangiopancreatography-guided biliary drainage (ERCP-BD). Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) may reduce early RBO in cases of asymptomatic DI, even when ERCP is possible.
Methods
We enrolled 56 patients with pancreatic cancer and asymptomatic DI who underwent EUS-HGS (n=25) or ERCP-BD (n=31). Technical and clinical success, early (<3 months) and overall RBO rates, time to RBO (TRBO), and adverse events were compared between the EUS-HGS and ERCP-BD groups. Risk factors for early RBO were also evaluated.
Results
Baseline characteristics were similar between the groups. Both procedures demonstrated 100% technical and clinical success rates, with a similar incidence of adverse events (48% vs. 39%, p=0.59). While the median TRBO was comparable (5.7 vs. 8.8 months, p=0.60), EUS-HGS was associated with a lower incidence of early RBO compared to ERCP-BD (8% vs. 29%, p=0.09). The major causes of early RBO in ERCP-BD were sludge and food impaction, rarely occurring in EUS-HGS. EUS-HGS was potentially reduced early RBO (odds ratio, 0.32; p=0.07).
Conclusions
EUS-HGS can be a viable option for treating pancreatic cancer with asymptomatic DI.

Citations

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Endoscopic Retrograde Cholangiopancreatography‐guided Biliary Drainage with Duckbill‐type Anti‐reflux Metal Stent versus Endoscopic Ultrasound‐guided Hepaticogastrostomy for Malignant Distal Biliary Obstruction in Pancreatic Cancer with Duodenal Invasion
Tsuyoshi Takeda, Takashi Sasaki, Tatsuki Hirai, Yoichiro Sato, Yuri Maegawa, Takafumi Mie, Takaaki Furukawa, Yukari Suzuki, Takeshi Okamoto, Masato Ozaka, Naoki Sasahira
DEN Open.2026;[Epub] CrossRef
Impact of Peri‐Procedural Antibiotics on Post‐ERCP Infectious Adverse Events With Distal Malignant Biliary Obstruction
Tatsunori Satoh, Haruna Takahashi, Eiji Nakatani, Yosuke Kobayashi, Fumitaka Niiya, Junichi Kaneko, Kazuma Ishikawa, Kenta Ito, Tetsushi Azami, Jun Noda, Shinya Kawaguchi
Journal of Gastroenterology and Hepatology.2026; 41(2): 696. CrossRef
Endoscopic Ultrasound‐Guided Hepaticogastrostomy With Plastic Stents in Comparison to Transpapillary Drainage With Metallic Stents for Unresectable Malignant Distal Biliary Obstructions
Hidehito Sumiya, Yoshihide Kanno, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Toshitaka Sakai, Keisuke Yonamine, Kazuaki Miyamoto, Fumisato Kozakai, Haruka Okano, Kento Hosokawa, Shun Nozaki, Kei Ito
DEN Open.2026;[Epub] CrossRef
Update on biliary endoscopy: a comprehensive review
Yukiko Takayama, Yousuke Nakai, Ryunosuke Hakuta, Ryota Nakabayashi, Nao Otsuka, Noriko Ishigaki, Masataka Kikuyama
Expert Review of Gastroenterology & Hepatology.2026; 20(5): 485. CrossRef
Role of Endoscopic Ultrasonography in Management of Pancreaticobiliary Cancers: Recent Trends and Advances
Shivangini Duggal, Mutaz Kalas, Mohamed H. Eldesouki, M. Ammar Kalas, Sherif E. Elhanafi
Cancers.2026; 18(12): 1864. CrossRef
Biliary drainage in pancreatic cancer with duodenal invasion: which route is the best?
Tanyaporn Chantarojanasiri, Thawee Ratanachu-Ek
Clinical Endoscopy.2025; 58(1): 82. CrossRef
EUS-Guided Gallbladder Drainage of Inoperable Malignant Distal Biliary Obstruction by Lumen-Apposing Metal Stent: Systematic Review and Meta-Analysis
Tawfik Khoury, Moaad Farraj, Wisam Sbeit, Pietro Fusaroli, Giovanni Barbara, Cecilia Binda, Carlo Fabbri, Maamoun Basheer, Sarah Leblanc, Fabien Fumex, Rodica Gincul, Anthony Yuen Bun Teoh, Jérémie Jacques, Bertrand Napoléon, Andrea Lisotti
Cancers.2025; 17(12): 1983. CrossRef
Primary Endoscopic Ultrasound-Guided Biliary Drainage for Malignant Biliary Obstruction
Yousuke Nakai, Ryunosuke Hakuta, Ryota Nakabayashi, Yutaka Shimamatsu, Nao Otsuka, Yukiko Takayama
The Korean Journal of Pancreas and Biliary Tract.2025; 30(4): 159. CrossRef

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Hepatobiliary scintigraphy of bile excretion after endoscopic ultrasound-guided hepaticogastrostomy for malignant biliary obstruction: a retrospective study in Japan: Masanori Yamada, Kazuo Hara, Shin Haba, Takamichi Kuwahara, Nozomi Okuno, Yasuhiro Kuraishi, Takafumi Yanaidani, Sho Ishikawa, Tsukasa Yasuda, Toshitaka Fukui; Clin Endosc 2024;57(6):798-806. Published online August 20, 2024; DOI: https://doi.org/10.5946/ce.2023.291

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Background
/Aims: Hepatobiliary scintigraphy (HBS) is used to evaluate bile excretion. This study aimed to evaluate biliary excretion during endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) using HBS.
Methods
We retrospectively evaluated 78 consecutive patients with malignant extrahepatic biliary obstruction, who underwent HBS after EUS-HGS between April 2015 and July 2022. The peak time and decay rate were scored with 0, 1, or 2 points based on thresholds of 20 and 35 minutes, and 10% and 50%, respectively. A total score of 4 or 3 was considered indicative of good bile excretion, whereas scores of 2, 1, or 0 indicated poor bile excretion.
Results
The good and poor bile excretion groups included 40 and 38 cases, respectively. The group with good bile excretion had a significantly longer time to recurrent biliary obstruction compared to the poor bile excretion group (not reached vs. 124 days, p=0.026). Multivariate analysis identified the site of obstruction as a significant factor influencing good bile excretion (odds ratio, 3.39; 95% confidence interval, 1.01–11.4, p=0.049), with superior bile excretion observed in cases involving upper biliary obstruction compared to middle or lower biliary obstruction.
Conclusions
In patients with malignant biliary obstruction who underwent HGS, the site of obstruction is significantly associated with stent patency.

Citations

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Endoscopic ultrasound-guided transpapillary versus transluminal biliary stenting: randomized comparison of long-term stent patency
Vinay Dhir, Vivek Kumar Singh, Sundeep Lakhtakia, Rajesh Puri, Praveer Rai, Nonthalee Pausawasdi, Ryosuke Tonozuka, Jahangeer Basha, Varayu Prachayakul, Abhishek Kathuria, Pankaj Kumar, Takao Itoi, D. Nageshwar Reddy
Endoscopy.2026; 58(05): 493. CrossRef

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Safety and efficacy of novel oblique-viewing scope for B2-endoscopic ultrasound-guided hepaticogastrostomy: Sho Ishikawa, Kazuo Hara, Nozomi Okuno, Nobumasa Mizuno, Shin Haba, Takamichi Kuwahara, Yasuhiro Kuraishi, Takafumi Yanaidani, Masanori Yamada, Tsukasa Yasuda, Toshitaka Fukui, Teru Kumagi, Yoichi Hiasa; Clin Endosc 2024;57(4):527-533. Published online March 29, 2024; DOI: https://doi.org/10.5946/ce.2023.129

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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.

Citations

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Enhanced Endoscope is Associated With Success Rates in B2‐ Endoscopic Ultrasound‐Guided Hepaticogastrostomy
Yoshitaro Yamamoto, Kazuo Hara, Nozomi Okuno, Shin Haba, Takamichi Kuwahara, Hiroki Koda, Minako Urata, Takashi Kondo, Keigo Oshiro, Tomoki Ogata, Ren Kuwabara
DEN Open.2026;[Epub] CrossRef
Clinical evaluation of a novel fluoroscopic mode for improving visibility during interventional endoscopic ultrasound (with video)
Naoto Aoyama, Takeshi Ogura, Saori Ueno, Atsushi Okuda, Nobu Nishioka, Jun Sakamoto, Yuki Uba, Mitsuki Tomita, Nobuhiro Hattori, Junichi Nakamura, Kimi Bessho, Takafumi Kanadani, Hiroki Nishikawa
Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef
Scope withdrawal technique to prevent transesophageal puncture during endoscopic ultrasound-guided hepaticogastrostomy
Kazuki Endo, Haruo Miwa, Ritsuko Oishi, Hiromi Tsuchiya, Yuichi Suzuki, Kazushi Numata, Shin Maeda
Endoscopy.2025; 57(S 01): E705. CrossRef
Primary endoscopic ultrasound-guided hepaticogastrostomy for biliary drainage prior to pancreatoduodenectomy: a retrospective study in Japan
Nozomi Okuno, Kazuo Hara, Seiji Natsume, Masataka Okuno, Shin Haba, Tomonari Asano, Takamichi Kuwahara, Hiroki Koda, Yasuhiro Shimizu
Clinical Endoscopy.2025; 58(4): 604. CrossRef
Dedicated Echoendoscope for Interventional Endoscopic Ultrasound: Comparison with a Conventional Echoendoscope
Toshio Fujisawa, Shigeto Ishii, Yousuke Nakai, Hirofumi Kogure, Ko Tomishima, Yusuke Takasaki, Koichi Ito, Sho Takahashi, Akinori Suzuki, Hiroyuki Isayama
Journal of Clinical Medicine.2024; 13(10): 2840. CrossRef

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Safety of endoscopic ultrasound-guided hepaticogastrostomy in patients with malignant biliary obstruction and ascites: Tsukasa Yasuda, Kazuo Hara, Nobumasa Mizuno, Shin Haba, Takamichi Kuwahara, Nozomi Okuno, Yasuhiro Kuraishi, Takafumi Yanaidani, Sho Ishikawa, Masanori Yamada, Toshitaka Fukui; Clin Endosc 2024;57(2):246-252. Published online September 7, 2023; DOI: https://doi.org/10.5946/ce.2023.075

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Background
/Aims: Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (EUS-HGS) is useful for patients with biliary cannulation failure or inaccessible papillae. However, it can lead to serious complications such as bile peritonitis in patients with ascites; therefore, development of a safe method to perform EUS-HGS is important. Herein, we evaluated the safety of EUS-HGS with continuous ascitic fluid drainage in patients with ascites.
Methods
Patients with moderate or severe ascites who underwent continuous ascites drainage, which was initiated before EUS-HGS and terminated after the procedure at our institution between April 2015 and December 2022, were included in the study. We evaluated the technical and clinical success rates, EUS-HGS-related complications, and feasibility of re-intervention.
Results
Ten patients underwent continuous ascites drainage, which was initiated before EUS-HGS and terminated after completion of the procedure. Median duration of ascites drainage before and after EUS-HGS was 2 and 4 days, respectively. Technical success with EUS-HGS was achieved in all 10 patients (100%). Clinical success with EUS-HGS was achieved in 9 of the 10 patients (90 %). No endoscopic complications such as bile peritonitis were observed.
Conclusions
In patients with ascites, continuous ascites drainage, which is initiated before EUS-HGS and terminated after completion of the procedure, may prevent complications and allow safe performance of EUS-HGS.

Citations

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Phase I/II Prospective Study on Endoscopic Ultrasound‐Guided Hepaticogastrostomy as Primary Drainage for Unresectable Malignant Hilar Biliary Obstruction
Tomoki Ogata, Kazuo Hara, Nozomi Okuno, Shin Haba, Takamichi Kuwahara, Shimpei Matsumoto, Hiroki Koda, Keigo Oshiro
DEN Open.2027;[Epub] CrossRef
Prevention of Adverse Events in Endoscopic Ultrasound‐Guided Biliary Drainage
Hirotoshi Ishiwatari, Hiroki Sakamoto, Takuya Doi, Masahiro Yamamura
DEN Open.2026;[Epub] CrossRef
Clinical Outcomes and Learning Curve of Endoscopic Ultrasound‐Guided Hepaticogastrostomy During the Implementation Phase in Inexperienced Centers: A Multicenter Retrospective Study
Junichi Kaneko, Tatsunori Satoh, Yosuke Kobayashi, Azumi Suzuki, Shinya Kawaguchi
DEN Open.2026;[Epub] CrossRef
EUS-guided pancreatic duct drainage—technical tips and outcomes: narrative review
Yasunobu Yamashita, Masayuki Kitano
Therapeutic Advances in Gastroenterology.2026;[Epub] CrossRef
Endosonografisch gesteuerte Gallengangsdrainage im chirurgischen Behandlungskonzept
Kai Koch, Markus Dollhopf
Allgemein- und Viszeralchirurgie up2date.2026; 20(02): 177. CrossRef
Feasibility and safety of EUS-guided biliary drainage in inexperienced centers: a multicenter study in southwest Japan
Takehiko Koga, Yusuke Ishida, Shunpei Hashigo, Yuzo Shimokawa, Hirofumi Harima, Kazuhisa Okamoto, Akihisa Ohno, Tsukasa Miyagahara, Toshihiro Fujita, Satoshi Fukuchi, Kosuke Takahashi, Hiroki Taguchi, Norimasa Araki, Yuichiro Ohtsuka, Toshiyuki Uekitani,
Gastrointestinal Endoscopy.2025; 101(4): 843. CrossRef
Clinical effect of percutaneous hepatic puncture biliary drainage combined with metal stent implantation in the treatment of malignant obstructive jaundice
Shoulin Zhang, Shaopeng Huang, Zheng Xing, Youwen Song, Fujian Yuan
BMC Surgery.2025;[Epub] CrossRef
Efficacy and safety of endoscopic ultrasound-guided hepaticogastrostomy for biliary drainage in hypervascular hepatocellular carcinoma: a retrospective study from Japan
Kenneth Tachi, Kazuo Hara, Nozomi Okuno, Shin Haba, Takamichi Kuwahara, Toshitaka Fukui, Ahmed Mohammed Sadek, Hossam El-Din Shaaban Mahmoud Ibrahim, Minako Urata, Takashi Kondo, Yoshitaro Yamamoto
Clinical Endoscopy.2025; 58(3): 448. CrossRef
Technical Review on Endoscopic Ultrasound-Guided Hepaticogastrostomy
Vivek Kumar Singh, Vinay Dhir
Journal of Digestive Endoscopy.2025; 16(04): 213. CrossRef
Moderne Ansätze der Gallengangsdrainage: Endosonografisch geführte Techniken im Vergleich
Kai Koch, Markus Dollhopf
Gastroenterologie up2date.2025; 21(03): 221. CrossRef
Management of iatrogenic perforations during endoscopic interventions in the hepato-pancreatico-biliary tract
Kirsten Boonstra, Rogier P. Voermans, Roy L.J. van Wanrooij
Best Practice & Research Clinical Gastroenterology.2024; 70: 101890. CrossRef
Is Endoscopic Ultrasound-Guided Hepaticogastrostomy Safe and Effective after Failed Endoscopic Retrograde Cholangiopancreatography?—A Systematic Review and Meta-Analysis
Saqr Alsakarneh, Mahmoud Y. Madi, Dushyant Singh Dahiya, Fouad Jaber, Yassine Kilani, Mohamed Ahmed, Azizullah Beran, Mohamed Abdallah, Omar Al Ta’ani, Anika Mittal, Laith Numan, Hemant Goyal, Mohammad Bilal, Wissam Kiwan
Journal of Clinical Medicine.2024; 13(13): 3883. CrossRef
Endoscopic ultrasound-guided antegrade stenting combined with closure of the puncture route using self-assembling peptide solution in a jaundiced patient with ascites
Hirotsugu Maruyama, Kojiro Tanoue, Tatsuya Kurokawa, Yoshinori Shimamoto, Yuki Ishikawa-Kakiya, Akira Higashimori, Yasuhiro Fujiwara
Endoscopy.2024; 56(S 01): E953. CrossRef
The Role of Therapeutic Endoscopic Ultrasound in Management of Malignant Double Obstruction (Biliary and Gastric Outlet): A Comprehensive Review with Clinical Scenarios
Giuseppe Dell’Anna, Rubino Nunziata, Claudia Delogu, Petra Porta, Maria Vittoria Grassini, Jahnvi Dhar, Rukaia Barà, Sarah Bencardino, Jacopo Fanizza, Francesco Vito Mandarino, Ernesto Fasulo, Alberto Barchi, Francesco Azzolini, Guglielmo Albertini Petron
Journal of Clinical Medicine.2024; 13(24): 7731. CrossRef

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Increasing trend of endoscopic drainage utilization for the management of pancreatic pseudocyst: insights from a nationwide database: Khaled Elfert, Salomon Chamay, Lamin Dos Santos, Mouhand Mohamed, Azizullah Beran, Fouad Jaber, Hazem Abosheaishaa, Suresh Nayudu, Sammy Ho; Clin Endosc 2024;57(1):105-111. Published online August 4, 2023; DOI: https://doi.org/10.5946/ce.2023.054

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Background
/Aims: The pancreatic pseudocyst (PP) is a type of fluid collection that typically develops as a delayed complication of acute pancreatitis. Drainage is indicated for symptomatic patients and/or associated complications, such as infection and bleeding. Drainage modalities include percutaneous, endoscopic, laparoscopic, and open drainage. This study aimed to assess trends in the utilization of different drainage modalities for treating PP from 2016 to 2020. The trends in mortality, mean length of hospital stay, and mean hospitalization costs were also assessed.
Methods
The National Inpatient Sample database was used to obtain data. The variables were generated using International Classification of Diseases-10 diagnostic and procedural codes.
Results
Endoscopic drainage was the most commonly used drainage modality in 2018–2020, with an increasing trend over time (385 procedures in 2018 to 515 in 2020; p=0.003). This is associated with a decrease in the use of other drainage modalities. A decrease in the hospitalization cost for PP requiring drainage was also noted (29,318 United States dollar [USD] in 2016 to 18,087 USD in 2020, p<0.001).
Conclusions
Endoscopic drainage is becoming the most commonly used modality for the treatment of PP in hospitals located in the US. This new trend is associated with decreasing hospitalization costs.

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Comparative Effectiveness of Endoscopic and Percutaneous Drainage of Walled-Off Pancreatic Necrosis
Mohamed Eldesouki, Khaled Elfert, Mohamed A. Aldemerdash, Mohamed Elgozair, Muhammad M. Elsharkawy, Mohamed Youssef, Muhammad Umair Khan, Shyam Thakkar, Michel Kahaleh
Journal of Clinical Gastroenterology.2026;[Epub] CrossRef
Asparaginase-Associated Pancreatitis and Pancreatic Pseudocyst Managed with Endoscopic Cystogastrostomy in Adult Acute Lymphoblastic Leukemia
Gyewon Park, Eun Sun Kim, Hyuk Soon Choi, Bora Keum, Yoon Tae Jeen, Hoon Jai Chun, Hong Sik Lee, Jae Min Lee
The Korean Journal of Pancreas and Biliary Tract.2025; 30(1): 31. CrossRef
Analysis of the correlation between serum MIF, MCP-1, and IL-6 levels and the formation of pseudocysts in patients with acute severe pancreatitis
Changcheng Liu, Xianru Jia, Bingbing Cui, Xuejin Liu
AIP Advances.2025;[Epub] CrossRef
Modern approaches to surgical treatment of pancreatic head pseudocysts
Duy Khanh Dao, Nicolai A. Sizonenko, Valery R. Goltsov
Bulletin of the Russian Military Medical Academy.2025; 27(3): 421. CrossRef
Pancreatic pseudocyst: The past, the present, and the future
Jonathan GA Koo, Matthias Yi Quan Liau, Igor A Kryvoruchko, Tamer AAM Habeeb, Christopher Chia, Vishal G Shelat
World Journal of Gastrointestinal Surgery.2024; 16(7): 1986. CrossRef

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Review

Clinical practice guidelines for percutaneous endoscopic gastrostomy: Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee, Korean Society of Gastrointestinal Endoscopy Task Force on Clinical Practice Guidelines; Clin Endosc 2023;56(4):391-408. Published online June 23, 2023; DOI: https://doi.org/10.5946/ce.2023.062

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With an aging population, the number of patients with difficulty in swallowing due to medical conditions is gradually increasing. In such cases, enteral nutrition is administered through a temporary nasogastric tube. However, the long-term use of a nasogastric tube leads to various complications and a decreased quality of life. Percutaneous endoscopic gastrostomy (PEG) is the percutaneous placement of a tube into the stomach that is aided endoscopically and may be an alternative to a nasogastric tube when enteral nutritional is required for four weeks or more. This paper is the first Korean clinical guideline for PEG developed jointly by the Korean College of Helicobacter and Upper Gastrointestinal Research and led by the Korean Society of Gastrointestinal Endoscopy. These guidelines aimed to provide physicians, including endoscopists, with the indications, use of prophylactic antibiotics, timing of enteric nutrition, tube placement methods, complications, replacement, and tube removal for PEG based on the currently available clinical evidence.

Citations

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