Endoscopic biliary recanalization by using a needle catheter in patients with complete ligation or stricture of the bile duct: safety and feasibility of a novel technique (with videos)

Gupta, Kapil; Aparicio, Dayse P.; Freeman, Martin L.; Sakai, Christiano; Paione, Jose B.; Artifon, Everson L.A.

doi:10.1016/j.gie.2011.03.1234

Cited by 8 publications

(5 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The key to this technique was puncturing the CP toward the deemed direction of the proximal bile duct. Another needle puncture technique under ERCP guidance has been reported 16 ; it was performed blindly and required straight alignment of the bile duct above and below the stricture. In this study, the puncture was visualized, and the direction could be adjusted by cholangioscope.…”

Section: Discussionmentioning

confidence: 99%

“…Compared with the sharp puncture tools, such as needle-knife (visually or blindly), the hard-tip guidewire puncture under cholangioscopy is safer. The most serious complication of needle-knife puncture or electrotomy is hemobilia, with a reported incidence of 6.0% 16 , 25 and excessive electrotomy could even cause hepatic abscess and bile leakage. However, in this study, no complications related to puncture procedure, e.g., biliary bleeding, bile leakage, perforation, or vascular injury, were observed.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Safety and feasibility of a novel recanalization technique using guidewire puncture under cholangioscopy for complete biliary stricture after liver transplantation

Zhang

Sun

Dong

et al. 2023

Sci Rep

View full text Add to dashboard Cite

Cholangioscopy is reportedly useful for selective guidewire placement across difficult biliary strictures, but few methods are available for complete stricture of biliary anastomosis. This study aimed to propose a guidewire puncture technique to recanalize totally obstructed anastomosis and discuss its safety and feasibility. From January 2015 to December 2021, a total of 11 patients with complete biliary anastomotic stricture after liver transplantation were enrolled. These patients underwent peroral single operator cholangioscopy (SpyGlass), whereas two failed cases on SpyGlass finally underwent percutaneous transhepatic cholangioscopy (PTCS). The steps of the recanalization technique were as follows: the stricture was viewed carefully to detect the closure point (CP) of the scar endoscopically, then the CP was targeted by the hard tip of the guidewire and broke through under guidance of the cholangioscope and fluoroscope. Complete occlusions were confirmed by SpyGlass in all cases. A total of 13 hard-tip guidewire punctures were performed under cholangioscopy, and ten punctures were successful (technical success rate, 76.9% [10/13]). After recanalization of the occluded anastomosis, plastic stent or metallic stent was deployed in three and seven patients, respectively. No procedure-related complications occurred during or after the cholangioscopy-assisted guidewire puncture. After a mean follow-up of 12 months, stents had been removed in five patients. The other six patients were still receiving stent treatment. This study demonstrated that the guidewire puncture technique under cholangioscopy is safe and feasible for complete stricture of biliary anastomosis, and the success rate is satisfactory.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Safety and feasibility of a novel recanalization technique using guidewire puncture under cholangioscopy for complete biliary stricture after liver transplantation

Zhang

Sun

Dong

et al. 2023

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Recently various case reports and series have been published in which complete biliary occlusions were treated by percutaneous cholangioscopic [5,6] and fluoroscopic [7,8] interventions. In another case series, the retrograde recanalization of complete, fibrotic subhepatic biliary occlusions by ERCP with a special catheter has been described [9].…”

Section: Background and Aimsmentioning

confidence: 99%

Endoscopic neo-anastomosis by Rendez-vous technique for the treatment of complete occlusion of bilioenteric anastomoses and distal bile ducts (case series)

et al. 2021

View full text Add to dashboard Cite

Background and aims The complete occlusion of bilioenteric anastomoses is a rare and challenging clinical condition. Repeated surgery is burdened with technical difficulties and significant morbidity. We report the first series of completely occluded bilioenteric anastomoses resp. distal bile duct successfully treated by simultaneous percutaneous and retrograde endoscopic interventions. Patients and methods This case series includes 4 patients with obstructive jaundice and/or recurring cholangitis and pain due to complete fibrotic occlusion of a hepaticojejunostomy (3 patients) and the distal bile duct (1 patient). After performing PTCD and stepwise dilation of the biliocutaneous tract, we tried to approach the occluded anastomosis from 2 sides by simultaneous percutaneous cholangioscopy and peroral device-assisted enteroscopy/duodenoscopy. By cutting through the separating tissue layer with a needle knife under endoscopic and fluoroscopic control using diaphanoscopy, a new anastomosis should be established followed by dilation of the neoanastomosis with subsequent percutaneous transhepatic drainage for a minimum of 1 year to prevent re-occlusion. Results The Rendez-vous maneuver was successful in 3/4 cases. In one case, the retrograde access to the anastomosis failed, so the neoanastomosis was cut under cholangioscopic and fluoroscopic guidance only. The neoanastomosis could be established successfully in all 4 cases. Jaundice, cholangitis, and pain disappeared. Minor periinterventional adverse events were cholangitis (n = 1) and pneumonia (n = 1) due to aspiration, which could be managed conservatively. No serious adverse events were observed, and no re-occlusion of any neoanastomosis occurred during the follow-up before and after removal of the percutaneous drainage. Conclusion Simultaneous percutaneous cholangioscopy and device-assisted enteroscopy/duodenoscopy with endoscopic creation of a neoanastomosis is a possible concept for the treatment of completely occluded bilioenteric anastomoses and distal bile ducts. This case series confirms the feasibility, safety, and long-term effectiveness of this treatment.

show abstract

“…Bile duct recanalization has previously been achieved using a combined percutaneous and endoscopic approach [2]. Gupta et al used a specific needle knife for puncture that allowed a wire to pass through the needle and stricture [3]. Recently, a standard needle knife has been used to cut and puncture these strictures [4].…”

mentioning

confidence: 99%

Needle knife recanalization of a complete post-transplant bile duct stricture

Mulki

Abdelfatah

2021

Endoscopy

View full text Add to dashboard Cite

Endoscopic biliary recanalization by using a needle catheter in patients with complete ligation or stricture of the bile duct: safety and feasibility of a novel technique (with videos)

Cited by 8 publications

References 6 publications

Safety and feasibility of a novel recanalization technique using guidewire puncture under cholangioscopy for complete biliary stricture after liver transplantation

Safety and feasibility of a novel recanalization technique using guidewire puncture under cholangioscopy for complete biliary stricture after liver transplantation

Endoscopic neo-anastomosis by Rendez-vous technique for the treatment of complete occlusion of bilioenteric anastomoses and distal bile ducts (case series)

Needle knife recanalization of a complete post-transplant bile duct stricture

Contact Info

Product

Resources

About