{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T10:31:45Z","timestamp":1788517905392,"version":"build-2803163510"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title>Background and Objectives:<\/jats:title>\n            <jats:p>The background of this study was to evaluate the outcomes of perihilar cholangiocarcinoma (pCCA) patients treated with EUS-guided hepaticogastrostomy (EUS-HGS).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>All patients with pCCA who underwent EUS-HGS from 2010 to 2020 were analyzed. The primary outcome was clinical success; the secondary outcomes were technical success, adverse events (AEs), stent patency, and oncological outcomes. Cox proportional-hazards regression and Kaplan\u2013Meier curves were analyzed to identify variables related to survival.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Thirty-four patients (50% females, 76 years old) were included; 24 (70.6%) presented with distant metastasis. Indications for EUS-HGS were ERCP failure (64.7%), duodenal stricture (23.5%), postsurgical anatomy (5.9%), and dilation limited to the left intrahepatic duct (5.9%). The technical success rate was 97.1%. The clinical success rate was 64.7%. Nine (26.5%) presented AEs, 2 fatal (bleeding and leakage). The overall survival was 91 (31-263) days. On multivariate analysis, EUS-HGS clinical success (Exp[b]: 0.23 [0.09-0.60]; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.003) and chemotherapy (Exp[b]: 0.06 [0.02-0.23]; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001) were significantly associated with survival. The survival was longer in patients who achieved EUS-HGS clinical success (178[61-393] <jats:italic toggle=\"yes\">vs<\/jats:italic>. 15[73-24] days; hazard ratio: 6.3; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001) and in those starting chemotherapy (324[178-439] <jats:italic toggle=\"yes\">vs<\/jats:italic>. 31 [9-48]; hazard ratio: 1.2; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>EUS-HGS is effective in pCCA patients despite a not negligible AE rate. Clinical success, potentially leading to jaundice resolution and chemotherapy start, significantly improves survival.<\/jats:p>\n          <\/jats:sec>","DOI":"10.4103\/eus-d-22-00014","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T11:10:10Z","timestamp":1670238610000},"page":"487-494","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Efficacy of EUS-guided hepaticogastrostomy in prolonging survival of patients with perihilar cholangiocarcinoma"],"prefix":"10.1097","volume":"11","author":[{"given":"Armelle","family":"Schoch","sequence":"first","affiliation":[{"name":"Endoscopic Department, Jean Mermoz Private Hospital, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lisotti","sequence":"additional","affiliation":[{"name":"Endoscopic Department, Jean Mermoz Private Hospital, Lyon, France"},{"name":"Hospital of Imola, University of Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Walter","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Edoard Herriot Hospital, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabien","family":"Fumex","sequence":"additional","affiliation":[{"name":"Endoscopic Department, Jean Mermoz Private Hospital, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Leblanc","sequence":"additional","affiliation":[{"name":"Endoscopic Department, Jean Mermoz Private Hospital, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Artru","sequence":"additional","affiliation":[{"name":"Endoscopic Department, Jean Mermoz Private Hospital, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00f4me","family":"Desram\u00e9","sequence":"additional","affiliation":[{"name":"Endoscopic Department, Jean Mermoz Private Hospital, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Brighi","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, IRCCS Institute for the Study of Cancer (IRST) \u201cDino Amadori\u201d, Meldola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Marsot","sequence":"additional","affiliation":[{"name":"Department of Radiology, Jean Mermoz Private Hospital, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Christophe","family":"Souquet","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Croix-Rousse Hospital, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Napol\u00e9on","sequence":"additional","affiliation":[{"name":"Endoscopic Department, Jean Mermoz Private Hospital, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,12,5]]},"reference":[{"key":"R1-20250826","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1093\/annonc\/mdw324","article-title":"Biliary cancer:ESMO clinical practice guidelines for diagnosis, treatment and follow-up","volume":"27","author":"Valle","year":"2016","journal-title":"Ann Oncol"},{"key":"R2-20250826","doi-asserted-by":"crossref","first-page":"2599","DOI":"10.3390\/cancers12092599","article-title":"Recent progress in the systemic treatment of advanced\/metastatic cholangiocarcinoma","volume":"12","author":"Fostea","year":"2020","journal-title":"Cancers (Basel)"},{"key":"R3-20250826","doi-asserted-by":"crossref","first-page":"1756284820948773","DOI":"10.1177\/1756284820948773","article-title":"Current status of treatment with immune checkpoint inhibitors for gastrointestinal, hepatobiliary, and pancreatic cancers","volume":"13","author":"Eso","year":"2020","journal-title":"Therap Adv Gastroenterol"},{"key":"R4-20250826","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1097\/00000658-199610000-00005","article-title":"Cholangiocarcinoma. 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