ArticleTherapeutic advances in gastroenterology2026
Guidewire-bile duct angle as a determinant of stent delivery success in EUS-guided hepaticogastrostomy: a prospective double-lumen dilator cohort with propensity score-matched historical controls.
Article in Therapeutic advances in gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
Background: Failure of stent delivery remains a major technical limitation of endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), often necessitating additional tract dilation and increasing procedural complexity and cost. Objectives: The aim of this study was to evaluate whether the guidewire-bile duct angle is associated with stent delivery success in EUS-HGS, and to explore whether a double-lumen dilator (DLD) is associated with procedural improvement consistent with an angle-mediated mechanism rather than direct mechanical advantage. Design: Prospective observational study with a propensity score-matched historical control. Methods: This was a prospective single-arm observational study of patients undergoing EUS-HGS using a DLD, compared with a propensity score-matched historical (retrospective) cohort that underwent conventional dilation. The main outcome was successful stent delivery without additional tract dilation. Results: A total of 25 patients in the DLD group were compared with 25 matched controls. Successful stent delivery without additional dilation was significantly higher in the DLD group than in the conventional group (92% vs 48%, Conclusion: In conclusion, the improvement associated with DLD use was consistent with an angle-mediated mechanism rather than a direct effect of dilation force; these findings should be regarded as hypothesis-generating mechanistic evidence rather than mechanistic proof.
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