{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:34:52Z","timestamp":1790778892452,"version":"4.1.0"},"reference-count":53,"publisher":"Georg Thieme Verlag KG","issue":"09","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n            Background Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is a valid option for EUS-guided biliary drainage that has been increasingly used in the last decade. The aims of this study were to provide a systematic review with meta-analysis and meta-regression of the features and outcomes of this procedure.<\/jats:p><jats:p>\n            Methods The MEDLINE, Scopus, Web of Science, and Cochrane databases were searched for literature pertinent to EUS-HGS. Meta-analysis of the proportions and meta-regression of potential modifiers of the main outcome measures were applied. The main outcome was technical success; secondary outcomes were clinical success and procedure-related adverse events (AEs).<\/jats:p><jats:p>\n            Results 33 studies, including 1644 patients, were included in the meta-analysis. Malignant biliary obstruction (MBO) was the underlying cause in almost all cases (99.6%); the main indications for EUS-HGS were duodenal\/papillary invasion (34.8%), surgically altered anatomy (18.4%), and hilar stenosis (16.0%). The pooled technical success of EUS-HGS was 97.7% (95%CI 96.1%\u201399.0%; I\n            2 = 0%), the intention-to-treat clinical success rate was 88.1% (95%CI 84.7%\u201391.2%; I\n            2 = 33.9%), and procedure-related AEs occurred in 12.0% (95%CI 9.8%\u201314.5%; I\n            2 = 20.4%), with cholangitis\/sepsis (2.8%) and bleeding (2.3%) the most frequent. The rate of procedure-related AEs was lower with the use of dedicated stents on univariable meta-regression analysis. Meta-regression showed that technical success and clinical success rates were modified by the centers\u2019 experience (&gt;4\/year).<\/jats:p><jats:p>\n            Conclusions EUS-HGS represents an effective and safe procedure for EUS-guided biliary drainage in patients with MBO. Future studies should address the impact of center experience, patient selection, and the use of dedicated stents to improve performance of this technique.<\/jats:p>","DOI":"10.1055\/a-2282-3350","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:51:30Z","timestamp":1709772690000},"page":"694-705","source":"Crossref","is-referenced-by-count":40,"title":["Efficacy and safety of endoscopic ultrasound-guided hepaticogastrostomy: a meta-regression analysis"],"prefix":"10.1055","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1148-9684","authenticated-orcid":false,"given":"Cecilia","family":"Binda","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec-Cesena Hospitals, AUSL della Romagna, Forl\u00ec-Cesena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2905-1146","authenticated-orcid":false,"given":"Elton","family":"Dajti","sequence":"additional","affiliation":[{"name":"European Reference Network on Hepatological Diseases, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy"},{"name":"Department of Medical and Surgical Sciences - DIMEC, Alma Mater Studiorum University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4628-1130","authenticated-orcid":false,"given":"Paolo","family":"Giuffrida","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec-Cesena Hospitals, AUSL della Romagna, Forl\u00ec-Cesena, Italy"},{"name":"Section of Gastroenterology & Hepatology, Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Trebbi","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec-Cesena Hospitals, AUSL della Romagna, Forl\u00ec-Cesena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Coluccio","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec-Cesena Hospitals, AUSL della Romagna, Forl\u00ec-Cesena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Cucchetti","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences - DIMEC, Alma Mater Studiorum University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0485-4903","authenticated-orcid":false,"given":"Alessandro","family":"Fugazza","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Digestive Endoscopy, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Perini","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec-Cesena Hospitals, AUSL della Romagna, Forl\u00ec-Cesena, Italy"},{"name":"Gastroenterology Unit, Azienda Ospedale Universita Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2211-6322","authenticated-orcid":false,"given":"Giulia","family":"Gibiino","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec-Cesena 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