{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T23:47:08Z","timestamp":1782431228194,"version":"3.54.5"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background Endoscopic ultrasound-guided hepatico-gastrostomy (EUS-HGS) enables internal biliary drainage via the stomach in patients with altered anatomy, inadequate left hepatic duct drainage, or duodenal obstruction. The technically demanding procedure is only performed at expert centers in the Netherlands. Most available evidence originates from selected cohorts, overestimating real-world outcomes. We evaluated outcomes of EUS-HGS in a nationwide cohort.<\/jats:p>\n                  <jats:p>Methods This nationwide retrospective cohort study included all patients in the Netherlands who underwent EUS-HGS attempts between 2009 and 2025, outside of prospective studies. The primary outcome was technical success. Secondary outcomes included clinical success, complications, time to recurrent biliary obstruction (RBO), and overall survival.<\/jats:p>\n                  <jats:p>Results A total of 107 procedures in 105 patients were analyzed (median age: 68 years [IQR: 59\u201376]; 55%: male). Technical success was achieved in 77% (81\/105). Failures were due to absence of a safe puncture tract (n = 7), unsuccessful bile duct puncture (n = 3), inability to achieve deep guidewire insertion (n = 3), failed fistula formation (n = 3), or unsuccessful or nonattempted stent placement (n = 7). Clinical success occurred in 78% of technically successful cases (63\/81), corresponding to 60% in intention-to-treat analysis (63\/105). Procedural complications occurred in 16\/107 (15%), and postprocedural complications in 17\/107 (16%). One procedure-related death occurred. RBO occurred in 28% (23\/81) during a median follow-up of 61 days [IQR: 23\u2013131]. Median overall survival was 91 days [IQR: 66\u2013155].<\/jats:p>\n                  <jats:p>Conclusion In this nationwide real-world cohort, technical and clinical success rates of EUS-HGS were modest compared with selected expert series, underscoring the need for prospective studies to improve patient selection, stent strategies, and procedural safety.<\/jats:p>","DOI":"10.1055\/a-2884-9422","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T23:01:47Z","timestamp":1780009307000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Bridging the Gap between Literature and Practice: Nationwide Outcomes of Endoscopic Ultrasound-guided Hepatico-gastrostomy"],"prefix":"10.1055","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5068-8227","authenticated-orcid":false,"given":"David M.","family":"de Jong","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Center, The Netherlands","place":["Rotterdam"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0616-7349","authenticated-orcid":false,"given":"Lydi M.J.W.","family":"van Driel","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Center, The Netherlands","place":["Rotterdam"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jurri\u00ebn G.P.","family":"Reijnders","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Center, The Netherlands","place":["Rotterdam"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7644-0668","authenticated-orcid":false,"given":"Akin","family":"Inderson","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center, The Netherlands","place":["Leiden"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0589-7059","authenticated-orcid":false,"given":"Jan Werner","family":"Poley","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Center, The Netherlands","place":["Maastricht"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0477-4532","authenticated-orcid":false,"given":"Roy L.J.","family":"van Wanrooij","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Noord-Holland, The Netherlands","place":["Amsterdam"],"department":["Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9969-019X","authenticated-orcid":false,"given":"Rogier P.","family":"Voermans","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Noord-Holland, The Netherlands","place":["Amsterdam"],"department":["Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Didden","sequence":"additional","affiliation":[{"name":"University Medical Centre Utrecht, The Netherlands","place":["Utrecht"],"department":["Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0482-1121","authenticated-orcid":false,"given":"Thomas R.","family":"de Wijkerslooth","sequence":"additional","affiliation":[{"name":"Antoni van Leeuwenhoek Ziekenhuis, The Netherlands","place":["Amsterdam"],"department":["Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5164-9148","authenticated-orcid":false,"given":"Foke","family":"van Delft","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center, The Netherlands","place":["Nijmegen"],"department":["Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9418-057X","authenticated-orcid":false,"given":"Niels G.","family":"Venneman","sequence":"additional","affiliation":[{"name":"Medical Spectrum Twente, The Netherlands","place":["Enschede"],"department":["Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5591-0499","authenticated-orcid":false,"given":"Robert C.","family":"Verdonk","sequence":"additional","affiliation":[{"name":"Sint Antonius Hospital, The Netherlands","place":["Nieuwegein"],"department":["Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna P.","family":"van Nes","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Center, The Netherlands","place":["Rotterdam"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9181-5499","authenticated-orcid":false,"given":"Marco J.","family":"Bruno","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Center, The Netherlands","place":["Rotterdam"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5455-5242","authenticated-orcid":false,"given":"Willem J.","family":"Lammers","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Center, The Netherlands","place":["Rotterdam"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"issue":"09","key":"ref1","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1055\/a-0659-9864","article-title":"Endoscopic biliary stenting: indications, choice of stents, and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline \u2013 updated October 2017","volume":"50","author":"J M Dumonceau","year":"2018","journal-title":"Endoscopy"},{"issue":"09","key":"ref2","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1055\/a-2282-3350","article-title":"Efficacy and safety of endoscopic ultrasound-guided hepaticogastrostomy: a meta-regression analysis","volume":"56","author":"C Binda","year":"2024","journal-title":"Endoscopy"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"4","DOI":"10.4103\/EUS-D-21-00009","article-title":"EUS-guided versus percutaneous transhepatic cholangiography biliary drainage for obstructed distal malignant biliary strictures in patients who have failed endoscopic retrograde cholangiopancreatography: a systematic review and meta-analysis","volume":"11","author":"U Hayat","year":"2022","journal-title":"Endosc Ultrasound"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1055\/a-1717-1391","article-title":"Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) guideline","volume":"54","author":"S W van der Merwe","year":"2022","journal-title":"Endoscopy"},{"issue":"09","key":"ref5","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1055\/s-0034-1391988","article-title":"Endoscopic ultrasound-guided biliary drainage after failed ERCP: cumulative experience of 101 procedures at a single center","volume":"47","author":"L Poincloux","year":"2015","journal-title":"Endoscopy"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1177\/1756283X17702096","article-title":"Endoscopic ultrasound-guided hepaticogastrostomy versus percutaneous transhepatic drainage for malignant biliary obstruction after failed endoscopic retrograde cholangiopancreatography: a retrospective expertise-based study from two centers","volume":"10","author":"A Sportes","year":"2017","journal-title":"Ther Adv Gastroenterol"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"301","DOI":"10.5946\/ce.2021.103","article-title":"What you need to know before performing endoscopic ultrasound-guided Hepaticogastrostomy","volume":"54","author":"T Chantarojanasiri","year":"2021","journal-title":"Clin Endosc"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"515","DOI":"10.5946\/ce.2023.142","article-title":"Outcomes of partially covered self-expandable metal stents with different uncovered lengths in endoscopic ultrasound-guided hepaticogastrostomy: a Japanese retrospective study","volume":"57","author":"T Okamoto","year":"2024","journal-title":"Clin Endosc"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-025-12453-2","article-title":"EUS-guided hepaticogastrostomy using a dedicated partially covered stent in malignant biliary obstruction (EPSILON): a prospective cohort study","author":"E Smit","year":"2025","journal-title":"Surg Endosc"},{"issue":"9596","key":"ref10","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"370","author":"E von Elm","year":"2007","journal-title":"Lancet"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"196","DOI":"10.5009\/gnl20096","article-title":"Endoscopic ultrasound-guided Hepaticogastrostomy: technical review and tips to prevent adverse events","volume":"15","author":"T Ogura","year":"2021","journal-title":"Gut Liver"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1016\/j.gie.2021.11.038","article-title":"Novel classification for adverse events in GI endoscopy: the AGREE classification","volume":"95","author":"K J Nass","year":"2022","journal-title":"Gastrointest Endosc"},{"issue":"09","key":"ref13","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1055\/a-2580-1316","article-title":"Endoscopic ultrasound-guided choledochoduodenostomy results in fewer complications than percutaneous drainage following failed ERCP in malignant distal biliary obstruction","volume":"57","author":"M JP de Jong","year":"2025","journal-title":"Endoscopy"},{"issue":"04","key":"ref14","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1007\/s00261-019-02136-7","article-title":"Health-related quality of life evaluation in \u201cleft\u201d versus \u201cright\u201d access for percutaneous transhepatic biliary drainage using EORTC QLQBIL-21 questionnaire: a randomized controlled trial","volume":"45","author":"D Castiglione","year":"2020","journal-title":"Abdominal Radiol"},{"issue":"08","key":"ref16","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1002\/ueg2.12552","article-title":"Long-term outcomes of endoscopic ultrasound-guided hepaticogastrostomy in patients with malignant biliary obstruction","volume":"12","author":"A Hedjoudje","year":"2024","journal-title":"United European Gastroenterol J"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1067\/mge.2003.85","article-title":"EUS-cholangio-drainage of the bile duct: report of 4 cases","volume":"57","author":"E Burmester","year":"2003","journal-title":"Gastrointest Endosc"},{"issue":"03","key":"ref18","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/eus.0000000000000055","article-title":"Efficacy and safety of EUS-guided hepatogastrostomy: a systematic review and meta-analysis","volume":"13","author":"V Moond","year":"2024","journal-title":"Endosc Ultrasound"},{"issue":"02","key":"ref19","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.gie.2023.03.019","article-title":"Same-session double EUS-guided bypass versus surgical gastroenterostomy and hepaticojejunostomy: an international multicenter comparison","volume":"98","author":"M Bronswijk","year":"2023","journal-title":"Gastrointest Endosc"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"e70024","DOI":"10.1002\/deo2.70024","article-title":"Endoscopic ultrasound-guided choledochoduodenostomy versus hepaticogastrostomy combined with gastroenterostomy in malignant double obstruction (CABRIOLET_Pro): a prospective comparative study","volume":"5","author":"G Vanella","year":"2025","journal-title":"DEN Open"}],"container-title":["Endoscopy International Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2884-9422.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T23:23:07Z","timestamp":1782429787000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2884-9422"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,28]]},"references-count":19,"journal-issue":{"issue":"CP","published-online":{"date-parts":[[2026,1,13]]},"published-print":{"date-parts":[[2026]]}},"alternative-id":["a28849422"],"URL":"https:\/\/doi.org\/10.1055\/a-2884-9422","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2364-3722","2196-9736"],"issn-type":[{"value":"2364-3722","type":"print"},{"value":"2196-9736","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5,28]]},"published":{"date-parts":[[2026,5,28]]}}}