{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T08:09:16Z","timestamp":1770538156096,"version":"3.49.0"},"reference-count":32,"publisher":"The Korean Society of Gastrointestinal Endoscopy","issue":"4","license":[{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["e-ce.org"],"crossmark-restriction":true},"short-container-title":["Clin Endosc"],"published-print":{"date-parts":[[2025,7,30]]},"abstract":"<jats:p>Background\/Aims: Malignant lesions of the pancreatic head can cause obstructive jaundice requiring biliary drainage. However, the effect of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis and metal stents on surgical resection remains controversial. This study aimed to investigate the efficacy of primary endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) performed prior to pancreatoduodenectomy, excluding patients with biliary duct cancer.Methods: We retrospectively analyzed consecutive patients who underwent pancreatoduodenectomy at our institution between January 2019 and December 2022. The patients were divided into three groups: without biliary drainage (n=130), endoscopic biliary stenting (EBS) (n=57), and primary EUS-HGS (n=20).Results: The positivity rate of the intraoperative bile juice culture was significantly higher in the EBS group (p&lt;0.001). No significant difference was observed among the groups in terms of postoperative adverse events (Clavien-Dindo grade 3 or higher, p=0.784) or the positive rate of peritoneal lavage cytology (p=0.984). Seven patients in the EBS group (12.3%) experienced early adverse events related to biliary drainage (post-ERCP pancreatitis, n=3; acute cholecystitis, n=3; bile duct perforation, n=1), whereas none in the EUS-HGS group experienced adverse events.Conclusions: Primary EUS-HGS is technically feasible as a preoperative procedure and has no short-term postoperative disadvantages.<\/jats:p>","DOI":"10.5946\/ce.2024.218","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T03:22:16Z","timestamp":1739244136000},"page":"604-611","update-policy":"https:\/\/doi.org\/10.5946\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Primary endoscopic ultrasound-guided hepaticogastrostomy for biliary drainage prior to pancreatoduodenectomy: a retrospective study in 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