Technical feasibility of endoscopic ultrasound-guided liver abscess drainage for the right hepatic lobe using a novel metal stent as first-line treatment (with video).
ERCP
EUS
EUS-guided liver abscess drainage
liver abscess
percutaneous transhepatic liver abscess drainage
Journal
Gastrointestinal endoscopy
ISSN: 1097-6779
Titre abrégé: Gastrointest Endosc
Pays: United States
ID NLM: 0010505
Informations de publication
Date de publication:
12 Sep 2024
12 Sep 2024
Historique:
received:
01
04
2024
revised:
24
07
2024
accepted:
09
09
2024
medline:
15
9
2024
pubmed:
15
9
2024
entrez:
14
9
2024
Statut:
aheadofprint
Résumé
Although Endoscopic ultrasound-guided liver abscess drainage (EUS-LAD) has been developed, only the left hepatic or caudate lobe can traditionally be drained by EUS. However, there is no evidence for the technical feasibility of EUS-LAD for the right hepatic lobe. In this retrospective study, the technical feasibility of EUS-LAD using a novel partially covered self-expandable metal stent (PCSEMS) with an anti-migration system was evaluated as a first-line drainage technique for right hepatic lobe abscesses. This study included consecutive patients with right liver abscesses between December 2020 and February 2024. The primary outcome in this study was the technical success rate of EUS-LAD. Technical success of EUS-LAD was defined as successful stent deployment from the liver abscess to the duodenum. Clinical success, procedure time, duration of hospital stay, recurrence of liver abscess, and adverse events were evaluated as secondary outcomes. 19 patients were enrolled in this study. The location of the liver abscesses was mainly at segment 6. The mean size of the liver abscesses was 91.8 mm. The liver abscess could be identified under EUS guidance from the duodenum in 16 patients. Puncture using a 19-G needle was attempted, but the needle could not reach the liver abscess in one patient. The novel PCSEMS was successfully deployed in all patients. Technical success rate of EUS-LAD was 78.9% (15/19). Adverse events associated with the procedure were observed in 3 patients, but conservative treatment was successful. Clinical success was obtained in 14 patients (93.3%). The median duration of stent placement was 19 days (range, 7 to 41 days). The median follow-up period was 556 days, and recurrence of liver abscess was not observed in any patients. In conclusion, EUS-LAD for the right liver lobe using a novel PCSEMS can be feasible and safe.
Sections du résumé
BACKGROUND AND AIM
OBJECTIVE
Although Endoscopic ultrasound-guided liver abscess drainage (EUS-LAD) has been developed, only the left hepatic or caudate lobe can traditionally be drained by EUS. However, there is no evidence for the technical feasibility of EUS-LAD for the right hepatic lobe. In this retrospective study, the technical feasibility of EUS-LAD using a novel partially covered self-expandable metal stent (PCSEMS) with an anti-migration system was evaluated as a first-line drainage technique for right hepatic lobe abscesses.
METHOD
METHODS
This study included consecutive patients with right liver abscesses between December 2020 and February 2024. The primary outcome in this study was the technical success rate of EUS-LAD. Technical success of EUS-LAD was defined as successful stent deployment from the liver abscess to the duodenum. Clinical success, procedure time, duration of hospital stay, recurrence of liver abscess, and adverse events were evaluated as secondary outcomes.
RESULT
RESULTS
19 patients were enrolled in this study. The location of the liver abscesses was mainly at segment 6. The mean size of the liver abscesses was 91.8 mm. The liver abscess could be identified under EUS guidance from the duodenum in 16 patients. Puncture using a 19-G needle was attempted, but the needle could not reach the liver abscess in one patient. The novel PCSEMS was successfully deployed in all patients. Technical success rate of EUS-LAD was 78.9% (15/19). Adverse events associated with the procedure were observed in 3 patients, but conservative treatment was successful. Clinical success was obtained in 14 patients (93.3%). The median duration of stent placement was 19 days (range, 7 to 41 days). The median follow-up period was 556 days, and recurrence of liver abscess was not observed in any patients.
CONCLUSIONS
CONCLUSIONS
In conclusion, EUS-LAD for the right liver lobe using a novel PCSEMS can be feasible and safe.
Identifiants
pubmed: 39276803
pii: S0016-5107(24)03494-1
doi: 10.1016/j.gie.2024.09.013
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.