EUS-Guided Versus Percutaneous Transhepatic Drainage of Liver Abscesses: A Multicenter Endohepatology Study in Western Japan (EPIC-LA Study)

Ogura, Takeshi; Kuroda, Taira; Matsuura, Takanori; Kitadai, Jun; Kitagawa, Koh; Itonaga, Masahiro; Takeshita, Kotaro; Matsumori, Tomoaki; Emori, Tomoya; Takenaka, Mamoru; Imai, Hajime; Mandai, Koichiro; Shintani, Shuhei; Fujimori, Nao; Shiomi, Hideyuki; Asada, Masanori; Sagami, Ryota; Maruyama, Hirotsugu; Ikeura, Tsukasa; Shimatani, Masaaki; Nishikiori, Hidefumi; Matsumoto, Kazuyuki; Kokubu, Masahito; Kamada, Hideki; Ishida, Yusuke; Hakoda, Akitoshi; Kitano, Masayuki

doi:10.1111/den.70067

Permalink : https://ousar.lib.okayama-u.ac.jp/69794

ID	69794
フルテキストURL	fulltext.pdf 751 KB
著者	Ogura, Takeshi Pancreatobiliary Advanced Medical Center, Osaka Medical and Pharmaceutical University Hospital Kuroda, Taira Gastroenterology Center, Ehime Prefectural Hospital Matsuura, Takanori Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine Kitadai, Jun Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine Kitagawa, Koh Department of Gastroenterology, Nara Medical University Itonaga, Masahiro Second Department of Internal Medicine, Wakayama Medical University Takeshita, Kotaro Department of Gastroenterology, Tane General Hospital Matsumori, Tomoaki Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine Emori, Tomoya Department of Gastroenterology, Wakayama Rosai Hospital Takenaka, Mamoru Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine Graduate School of Medical Sciences Imai, Hajime Department of Gastroenterology, Okanami General Hospital Mandai, Koichiro Department of Gastroenterology, Kyoto Second Red Cross Hospital Shintani, Shuhei Department of Gastroenterology, Shiga University of Medical Science Fujimori, Nao Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University Shiomi, Hideyuki Division of Hepatobiliary and Pancreatic Diseases, Department of Gastroenterology, Hyogo Medical University Asada, Masanori Department of Gastroenterology and Hepatology, Japanese Red Cross Osaka Hospital Sagami, Ryota Department of Gastroenterology, Faculty of Medicine, Oita University Maruyama, Hirotsugu Department of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan University Ikeura, Tsukasa Division of Gastroenterology and Hepatology, Kansai Medical University Hospital Shimatani, Masaaki Department of Gastroenterology and Hepatology, Kansai Medical University Medical Center Nishikiori, Hidefumi Department of Gastroenterology, Oita San-ai Medical Center Matsumoto, Kazuyuki Department of Endoscopy, Okayama University Hospital ORCID Kaken ID publons Kokubu, Masahito Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine Kamada, Hideki Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University Ishida, Yusuke Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University Hakoda, Akitoshi 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University Kitano, Masayuki Second Department of Internal Medicine, Wakayama Medical University
抄録	Objective: Percutaneous transhepatic liver abscess drainage (PTAD) and endoscopic ultrasound-guided liver abscess drainage (EUS-LAD) have several limitations. Recently, because of technical improvements in echoendoscope maneuvers, EUS-guided access for the right hepatic lobe has been reported. The aim of this multicenter, retrospective study was to compare clinical outcomes of PTAD and EUS-LAD including the right hepatic lobe in West Japan. Method: This retrospective, multicenter study included consecutive patients with liver abscesses between January 2019 and November 2024. The primary outcome in this study was the clinical success rate compared between EUS-LAD and PTAD. Results: During the study period, 1012 consecutive patients developed liver abscesses. Of them, 734 patients were excluded, 43 underwent EUS-LAD and 235 patients underwent PTAD. After propensity score-matched analysis, the clinical success rate was significantly higher in the EUS-LAD group (97.7%, 42/43) than in the PTAD group (79.1%, 34/43) (p = 0.007). After a propensity score-matched analysis, 25 patients were included in each group. The clinical success rate was significantly higher in the EUS-LAD group (100%, 25/25) than in the PTAD group (84%, 21/25) (p = 0.037). Adverse events were also significantly higher in the PTAD group (16%, 5/25) than in the EUS-LAD group (p = 0.025). In addition, the median length of hospital stay was significantly shorter in the EUS-LAD group (15 days) than in the PTAD group (22 days) (p = 0.005). Conclusions: EUS-LAD using a metal stent might be one of the options, but further randomized, controlled trials are needed.
キーワード	drainage endoscopic ultrasound-guided liver abscess drainage EUS liver abscess percutaneous transhepatic liver abscess drainage
発行日	2025-11-27
出版物タイトル	Digestive Endoscopy
出版者	Wiley
ISSN	0915-5635
NCID	AA10907137
資料タイプ	学術雑誌論文
言語	英語
OAI-PMH Set	岡山大学
著作権者	© 2025 The Author(s).
論文のバージョン	publisher
PubMed ID	41307348
DOI	10.1111/den.70067
Web of Science KeyUT	001625112400001
関連URL	isVersionOf https://doi.org/10.1111/den.70067
ライセンス	http://creativecommons.org/licenses/by/4.0/
Citation	T. Ogura, T. Kuroda, T. Matsuura, et al., “ EUS-Guided Versus Percutaneous Transhepatic Drainage of Liver Abscesses: A Multicenter Endohepatology Study in Western Japan (EPIC-LA Study),” Digestive Endoscopy (2025): 1–9, https://doi.org/10.1111/den.70067.