Efficacy of a Novel Tapered Contrast Catheter for Endoscopic Ultrasound-Guided Hepaticogastrostomy: A Multicenter Study

Abstract

Background: Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is an alternative for failed endoscopic retrograde cholangiopancreatography (ERCP), with current success rates of 65-84% considered suboptimal. A novel ERCP catheter (SHOREN, Kaneka Corporation, Osaka, Japan) with a tapered 3.3-French tip may facilitate smoother insertion, potentially improving outcomes. Methods: This retrospective analysis encompassed EUS-HGS procedures conducted from January 2021 to August 2023 at four institutions. The aim of this study was to compare the performance of conventional and novel ERCP contrast catheters regarding the success rate of single-attempt catheter insertion, failure rates, technical success rates, and incidence of adverse events. Results: The study included 48 patients; 26 underwent EUS-HGS using conventional catheters and 22 with the novel catheter. The novel catheter achieved higher success rates in single-attempt insertions (96.5% vs. 80.8%) and lower failure rates (4.6% vs. 7.7%). The occurrence of bile peritonitis was comparable between the two groups. Conclusions: The novel ERCP contrast catheter with a tapered tip appears to contribute to successful catheter insertion and is useful for EUS-HGS.

Keywords: contrast catheter; endoscopic retrograde cholangiopancreatography; endoscopic ultrasound-guided hepaticogastrostomy; novel; retrospective study.

Figure 1

Image of the novel ERCP contrast catheter. This device has a 3.3-Fr tapered tip (yellow arrowhead) and a 5.9-Fr wider lumen (red arrowhead). Almost no gaps are observed at the top of the catheter. ERCP, endoscopic retrograde cholangiopancreatography; Fr, French.

Figure 2

Measurement of the insertion angle. The insertion angle (black arrowhead) is defined as the angle between the guidewire in the liver parenchyma (yellow dotted line) and the punctured peripheral intrahepatic bile duct (red dotted line).