Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
© 2024 Korean Society of Gastrointestinal Endoscopy
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflicts of Interest
The authors have no potential conflicts of interest.
Funding
None.
Author Contributions
Conceptualization: MY, KH; Date curation: MY; Formal analysis: MY; Investigation: MY, KH, NM, SH, TK, NO, YK; Methodology: MY, KH, NM, SH, TK, NO, YK; Resources: MY, TaY, SI, TsY, TF; Supervision: MY, KH; Writing–original draft: YM, KH; Writing–review & editing: all authors.
Characteristic | Value |
---|---|
Age (yr) | 68 (24–85) |
Sex (male) | 43 (55.1) |
Primary disease | |
Pancreatic cancer | 41 (52.6) |
Gastric cancer | 12 (15.4) |
Bile duct cancer | 5 (6.4) |
Duodenal cancer | 5 (6.4) |
Gallbladder cancer | 5 (6.4) |
Papillary cancer | 2 (2.6) |
Others | 8 (10.3) |
Indication for HGSa) | |
Primary drainage | 53 (67.9) |
Salvage drainage | 25 (32.1) |
Site of obstructionb) | |
Upper | 19 (24.4) |
Middle and lower | 59 (75.6) |
Duodenal stent | 16 (20.5) |
Surgically altered anatomy | 16 (20.5) |
Roux-en-Y | 7 (9.0) |
Gastrojejunostomy | 7 (9.0) |
Billroth-Ⅱ | 2 (2.6) |
Peritoneal dissemination | 20 (25.6) |
Ascites | 15 (19.2) |
Post-cholecystectomy | 6 (7.7) |
HGS route | |
B2 | 50 (64.1) |
B3 | 28 (35.9) |
Clinical success | 78 (100.0) |
Early (£30 days) adverse event | 4 (5.1) |
Peritonitis | 1 (moderate) |
Cholangitis | 2 (mild) |
Cholecystitis | 1 (moderate) |
Late (>30 days) adverse event | 1 (1.3) |
Biloma | 1 (moderate) |
Values are presented as median (range) or number (%).
HGS, hepaticogastrostomy.
a)Primary drainage, the first drainage; salvage drainage, conversion from other drainage, or additional drainage using another technique.
b)The site of bile duct obstruction was divided into upstream (upper biliary obstruction) and downstream areas (middle and lower biliary obstruction), bordering the confluence of the cystic duct, using computed tomography and magnetic resonance imaging.
Characteristic | Value |
---|---|
Age (yr) | 68 (24–85) |
Sex (male) | 43 (55.1) |
Primary disease | |
Pancreatic cancer | 41 (52.6) |
Gastric cancer | 12 (15.4) |
Bile duct cancer | 5 (6.4) |
Duodenal cancer | 5 (6.4) |
Gallbladder cancer | 5 (6.4) |
Papillary cancer | 2 (2.6) |
Others | 8 (10.3) |
Indication for HGS |
|
Primary drainage | 53 (67.9) |
Salvage drainage | 25 (32.1) |
Site of obstruction |
|
Upper | 19 (24.4) |
Middle and lower | 59 (75.6) |
Duodenal stent | 16 (20.5) |
Surgically altered anatomy | 16 (20.5) |
Roux-en-Y | 7 (9.0) |
Gastrojejunostomy | 7 (9.0) |
Billroth-Ⅱ | 2 (2.6) |
Peritoneal dissemination | 20 (25.6) |
Ascites | 15 (19.2) |
Post-cholecystectomy | 6 (7.7) |
HGS route | |
B2 | 50 (64.1) |
B3 | 28 (35.9) |
Clinical success | 78 (100.0) |
Early (£30 days) adverse event | 4 (5.1) |
Peritonitis | 1 (moderate) |
Cholangitis | 2 (mild) |
Cholecystitis | 1 (moderate) |
Late (>30 days) adverse event | 1 (1.3) |
Biloma | 1 (moderate) |
Variable | n/total n (%) | Univariate analysis |
Multivariate analysis |
||
---|---|---|---|---|---|
OR (95% CI) | p-value | OR (95% CI) | p-value | ||
Primary disease | |||||
Pancreatic cancer | 21/41 (51.2) | 0.994 (0.372–2.654) | 1 | ||
Others | 19/37 (51.4) | ||||
Site of obstruction | |||||
Upper | 14/19 (73.7) | 3.496 (1.022–14.077) | 0.035 | 3.39 (1.01–11.4) | 0.049 |
Middle and lower | 26/59 (44.1) | ||||
Duodenal stent | |||||
No | 35/62 (56.6) | 0.355 (0.086–1.272) | 0.095 | 0.507 (0.144–1.78) | 0.289 |
Yes | 5/16 (31.3) | ||||
Surgically altered anatomy | |||||
No | 34/62 (54.8) | 0.498 (0.131–1.737) | 0.268 | ||
Yes | 6/16 (37.5) | ||||
Peritoneal dissemination | |||||
No | 33/58 (56.9) | 0.412 (0.12–1.308) | 0.121 | 0.473 (0.132–1.69) | 0.25 |
Yes | 7/20 (35.0) | ||||
Ascites | |||||
No | 35/63 (55.6) | 0.404 (0.096–1.482) | 0.834 | 0.206 (0.222–3.37) | 0.799 |
Yes | 5/15 (33.3) | ||||
Post-cholecystectomy | |||||
No | 37/72 (51.4) | 1.056 (0.132–8.426) | 1 | ||
Yes | 3/6 (50.0) |
Values are presented as median (range) or number (%). HGS, hepaticogastrostomy. Primary drainage, the first drainage; salvage drainage, conversion from other drainage, or additional drainage using another technique. The site of bile duct obstruction was divided into upstream (upper biliary obstruction) and downstream areas (middle and lower biliary obstruction), bordering the confluence of the cystic duct, using computed tomography and magnetic resonance imaging.
OR, odds ratio; CI, confidence interval.