Enhanced Endoscope is Associated With Success Rates in B2‐ Endoscopic Ultrasound‐Guided Hepaticogastrostomy

ABSTRACT Objective Endoscopic ultrasound (EUS)‐guided hepaticogastrostomy (HGS) in intrahepatic bile duct segment 3 (B3) is widely used for biliary drainage. Post‐puncture procedures are easy to perform in intrahepatic bile duct segment 2 (B2), but using a conventional oblique‐viewing (OV) scope (GF‐UCT260) may result in transesophageal puncture. In this study, we compared the safety and efficacy of B2 puncture using a conventional OV scope, a novel OV scope (EG‐740UT), and a forward‐viewing (FV) scope (TGF‐UC260J). Methods This single‐center retrospective study investigated 319 consecutive patients in whom B2‐EUS‐HGS was attempted using an OV or FV between January 2017 and March 2024 at Aichi Cancer Center. Results In B2‐EUS‐HGS, the use of enhanced endoscopes (TGF‐UC260J and EG‐740UT) resulted in a relatively high technical success rate of 93.6% (205/219) and an overall clinical success rate of 97.1% (199/205). The enhanced endoscope group demonstrated a significantly higher technical success rate ( p < 0.001) compared to the conventional endoscope group. No significant differences were observed between the two groups in terms of overall clinical success rate ( p = 0.128) and early adverse event rate ( p = 0.461). Conclusions B2‐EUS‐HGS using either an FV or novel OV scope showed comparable safety with a high technical and overall clinical success rate. The use of an FV or novel OV scope seems to be a suitable strategy for performing B2‐EUS‐HGS. Clinical Trial Registration Study/trial registration and registration number were not applicable (N/A), as this study was a retrospective analysis using anonymized data.