Bleeding left hepatic artery pseudoaneurysm: a complication of endoscopic ultrasound-guided hepaticogastrostomy

Prachayakul, Varayu; Thamtorawat, Somrach; Siripipattanamongkol, C.; Thanathanee, P.

doi:10.1055/s-0033-1344064

Cited by 14 publications

(14 citation statements)

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“…The incidence of early adverse events of EUS‐HGS, including hemorrhage (3.7%), bile leakage (2.8%), biloma (2.6%), stent migration (1.6%), stent misplacement (intrahepatic, intraperitoneal) (1.2%), intrahepatic hematoma (1.2%) and sepsis (1.2%), was 18.2% (45/247 cases) . Other adverse events included perforation , abscess , acute cholangitis , pneumoperitoneum , intrahepatic hematoma , peritonitis , pseudoaneurysm of the hepatic artery , and biliary vomiting . Mortalities (2.0%) and cases of transfer to laparotomy (0.8%) were also reported .…”

Section: Questions and Clinical Questions Of The Guidelinesmentioning

confidence: 99%

Clinical practice guidelines for safe performance of endoscopic ultrasound/ultrasonography‐guided biliary drainage: 2018

Isayama

Nakai

Itoi

et al. 2019

J Hepato Biliary Pancreat

105

127

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Endoscopic ultrasound/ultrasonography‐guided biliary drainage (EUS‐BD) is a relatively new modality for biliary drainage after failed or difficult transpapillary biliary cannulation. Despite its clinical utility, EUS‐BD can be complicated by severe adverse events such as bleeding, perforation, and peritonitis. The aim of this paper is to provide practice guidelines for safe performance of EUS‐BD as well as safe introduction of the procedure to non‐expert centers. The guidelines comprised patient–intervention–comparison–outcome‐formatted clinical questions (CQs) and questions (Qs), which are background statements to facilitate understanding of the CQs. A literature search was performed using the PubMed and Cochrane Library databases. Statement, evidence level, and strength of recommendation were created according to the GRADE system. Four committees were organized: guideline creation, expert panelist, evaluation, and external evaluation committees. We developed 13 CQs (methods, device selection, supportive treatment, management of adverse events, education and ethics) and six Qs (definition, indication, outcomes and adverse events) with statements, evidence levels, and strengths of recommendation. The guidelines explain the technical aspects, management of adverse events, and ethics of EUS‐BD and its introduction to non‐expert institutions.

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Section: Questions and Clinical Questions Of The Guidelinesmentioning

confidence: 99%

Clinical practice guidelines for safe performance of endoscopic ultrasound/ultrasonography‐guided biliary drainage: 2018

Isayama

Nakai

Itoi

et al. 2019

J Hepato Biliary Pancreat

105

127

View full text Add to dashboard Cite

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“…Portal vein and hepatic artery injuries can cause immediate or delayed bleeding. Bleeding from a hepatic artery pseudoaneurysm after EUS-HGS has been reported, with all patients successfully treated with transarterial interventions [ 39 , 40 ]. If a vascular structure is accidentally punctured, bleeding can be prevented by retracting the needle until the tip is in the liver parenchyma, followed by reinsertion of the stylet to push back the retained clot inside the needle to occlude the puncture tract.…”

Section: Complications and Troubleshootingmentioning

confidence: 99%

What You Need to Know Before Performing Endoscopic Ultrasound-guided Hepaticogastrostomy

2021

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Endoscopic retrograde cholangiopancreatography (ERCP) is the primary treatment modality for bile duct obstruction. When ERCP is unsuccessful, percutaneous transhepatic biliary drainage can be an alternative method. Endoscopic ultrasound-guided biliary drainage (EUS-BD) has emerged as a treatment option for biliary obstruction, especially after ERCP failure. EUS-BD offers transluminal intrahepatic and extrahepatic drainage through a transgastric and transduodenal approach. EUS-guided hepaticogastrostomy (EUS-HGS) is an excellent choice for patients with hilar strictures or those with a surgically altered anatomy. The optimal steps in EUS-HGS are case selection, bile duct visualization, puncture-site selection, wire insertion and manipulation, tract dilation, and stent placement. Caution should be taken at each step to prevent complications. Dedicated devices for EUS-HGS have been developed to improve the technical success rate and reduce complications. This technical review focuses on the essential practical points at each step of EUS-HGS.

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“…3). Prachayakul et al 45 reported a case of coil embolization of a left hepatic artery pseudoaneurysm after EUS-guided hepaticogastrostomy for biliary drainage. The cause of bleeding was presumed to be the creation of the hepaticogastrostomy tract using a stent retriever.…”

Section: Endoscopic Ultrasound (Eus)-guided Proceduresmentioning

confidence: 99%

Endovascular hemostasis for endoscopic procedure-related gastrointestinal bleeding

Park

Kim

Shin

2019

Int J Gastrointest Interv

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Gastrointestinal (GI) bleeding is a common complication of various endoscopic procedures. In most cases, GI bleeding responds to conservative management. And if indicated, endoscopic hemostasis is performed. However, if endoscopic hemostasis fails due to massive bleeding or hemodynamically unstable patients, alternative treatment options, such as endovascular hemostasis or surgery, should be considered. As endoscopic procedures have become more diverse, there have been reports of interventional treatment of endoscopic, procedure-related GI bleeding. In this article we will discuss the endovascular diagnosis and treatment of endoscopic, procedure-related GI bleeding.

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Bleeding left hepatic artery pseudoaneurysm: a complication of endoscopic ultrasound-guided hepaticogastrostomy

Cited by 14 publications

References 0 publications

Clinical practice guidelines for safe performance of endoscopic ultrasound/ultrasonography‐guided biliary drainage: 2018

Clinical practice guidelines for safe performance of endoscopic ultrasound/ultrasonography‐guided biliary drainage: 2018

What You Need to Know Before Performing Endoscopic Ultrasound-guided Hepaticogastrostomy

Endovascular hemostasis for endoscopic procedure-related gastrointestinal bleeding

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