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6575508 
Journal Article 
Risk factors for adverse events associated with bile leak during EUS-guided hepaticogastrostomy 
Yamamoto, Y; Ogura, T; Nishioka, N; Yamada, T; Yamada, M; Ueno, S; Higuchi, K; , 
2020 
WOLTERS KLUWER MEDKNOW PUBLICATIONS 
MUMBAI 
9 
2 
110-115 
English 
32295968 
WOS:000529960200005 
Background and Objective: EUS-guided hepaticogastrostomy (HGS) is performed for patients with advanced cancer because of poor prognosis and compromised status, and bile peritonitis may prove critical for such patients. This adverse event has the possibility of decreasing quality of life by prolonging the time until the start of oral intake, hospital stay, or chemotherapy. Predictors of bile peritonitis in EUS-HGS thus have considerable clinical impact. The aim of this study was to retrospectively determine risk factors of bile peritonitis as adverse events of EUS-HGS. Patients and Methods: As risk factors of bile peritonitis, baseline characteristics of patients, characteristics of procedures such as number of punctures, types of fistula dilation, mean procedure time were analyzed. Furthermore, a receiver operating characteristic (ROC) curve was plotted to assess the influence of this distance and bile peritonitis and determine the optimum cutoff score for predicting the risk of bile peritonitis. Multivariate analysis using logistic regression was performed to examine factors of bile peritonitis. Results: A total of 68 patients were enrolled in this study. A distance of 2.50 cm offered 90.3% sensitivity and 87.5% specificity in predicting bile peritonitis according to the ROC curve. Number of punctures (>1), procedure time (>20 min), distance to the hepatic parenchyma (<2.50 cm), and presence of acute cholangitis were significantly associated with bile peritonitis in univariate analysis. However, according to this multivariate analysis, distance to the hepatic parenchyma (<2.50 cm, odds ratio 96.98, 95% confidence interval 10.12-929.12, P < 0.001) were only significantly associated with bile peritonitis. Conclusions: The short distance of hepatic parenchyma may be a risk factor of bile peritonitis. 
Adverse event; bile peritonitis; EUS-guided biliary drainage; EUS-guided hepaticogastrostomy; biliary drainage; metal stent; choledochoduodenostomy; guidelines; migration; consensus; Gastroenterology & Hepatology 
IRIS
• Inorganic Mercury Salts (2)
     Mercuric Sulfide
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