EUS-guided antegrade procedures

Mukai, Shuntaro; Itoi, Takao

doi:10.4103/eus.eus_46_19

Cited by 13 publications

(3 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, EUSguided antegrade stenting (AS) and antegrade intervention have been developed. [16][17][18][19] To perform these procedures, the guidewire should be manipulated and deployed across the stricture site using an ERCP catheter. Therefore, the ERCP catheter should be inserted into the biliary tract across the stomach and bile duct wall.…”

Section: Discussionmentioning

confidence: 99%

Moving scope technique improves technical success rate of device insertion during EUS-guided hepaticogastrostomy (with video)

Bessho,

Ogura,

Ueno

et al. 2023

Therap Adv Gastroenterol

View full text Add to dashboard Cite

Background: Technical tips for device insertion during endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) have not been reported. To improve the technical success rate of device insertion without unnecessary tract dilation, the pushing force should be transmitted directly from the channel of the echoendoscope to the intrahepatic bile duct. Objectives: We developed a novel technique, termed the ‘moving scope technique’, the feasibility of which during EUS-HGS is described. Design: Retrospective study. Methods: The primary outcome of this study was the technical success rate of dilation device insertion without electrocautery dilation after the moving scope technique. The initial technical success rate of dilation device insertion was defined as successful insertion into the biliary tract. If dilation device insertion failed, the moving scope technique was attempted. Results: A total of 143 patients were enrolled in this study. The initial technical success rate for device insertion was 80.4% (115/143). The moving scope technique was therefore attempted in 28 patients. The mean angle between the intrahepatic bile duct and the guidewire was improved to 141.0° and resulted in a technical success rate of 100% (28/28). The area under the ROC curve (AUC) was 0.88, and 120° predicted successful dilation device insertion with sensitivity of 88.0% and specificity of 78.8%. Bile peritonitis ( n = 8) and cholangitis ( n = 2) were observed as adverse events, but were not severe. Conclusion: In conclusion, the moving scope technique may be helpful during EUS-HGS to achieve successful insertion of the dilation device into the biliary tract. These results should be evaluated in a prospective randomized controlled trial.

show abstract

Section: Discussionmentioning

confidence: 99%

Moving scope technique improves technical success rate of device insertion during EUS-guided hepaticogastrostomy (with video)

Bessho,

Ogura,

Ueno

et al. 2023

Therap Adv Gastroenterol

View full text Add to dashboard Cite

show abstract

“…Thus, an ERCP cannula or a 6-Fr cystotome is recommended as an effective approach for guidewire manipulation. 66 This enables better pushability and torquing for the guidewire. Additionally, the catheter can be used for obtaining a cholangiogram, delineating the anatomy of the stricture and marking the papilla's exact location on fluoroscopy.…”

Section: Recommendation 14mentioning

confidence: 99%

Society of Gastrointestinal Endoscopy of India Consensus Guidelines on Endoscopic Ultrasound-Guided Biliary Drainage: Part II (Technical Aspects)

Samanta

Udawat

Chowdhary

et al. 2023

Journal of Digestive Endoscopy

View full text Add to dashboard Cite

Endoscopic management of bile duct obstruction is a key aspect in gastroenterology practice and has evolved since the first description of biliary cannulation by McCune et al in 1968. Over many decades, the techniques and accessories have been refined, and currently, the first-line management for extrahepatic biliary obstruction is endoscopic retrograde cholangiopancreatography (ERCP). However, even in expert hands, the success rate of ERCP reaches up to 95%. In almost 4 to 16% cases, failure to cannulate the bile duct may necessitate other alternatives such as surgical bypass or, more commonly, percutaneous transhepatic biliary drainage (PTBD). While surgery is associated with high morbidity and mortality, PTBD has a very high reintervention and complication rate (∼80%) and poor quality of life. Almost parallelly, endoscopic ultrasound (EUS) has come a long way from a mere diagnostic tool to a substantial therapeutic option in various pancreaticobiliary diseases. Biliary drainage using EUS-guidance (EUS-BD) has gained momentum since the first report published by Giovannini et al in 2001. The concept of accessing the bile duct through a different route than the papilla, circumventing the shortcomings of PTBD, and sometimes bypassing the actual obstruction have enthused a lot of interest in this novel strategy. The three key methods of EUS-BD entail transluminal, antegrade, and rendezvous approach. Over the past decade, with growing experience, EUS-BD has been found to be equivalent to ERCP or PTBD for malignant obstruction with better success rates. EUS-BD, however, is not devoid of adverse events and can carry fatal adverse events. However, neither the technique of EUS-BD nor the accessories and stents for EUS-BD have been standardized. Additionally, different countries and regions have different availability of the accessories, making generalizability a difficult task. Thus, technical aspects of this evolving therapy need to be outlined. For these reasons, Society of Gastrointestinal Endoscopy of India (SGEI) deemed it appropriate to develop technical consensus statements for performing safe and successful EUS-BD.

show abstract

“…EUS-guided hepaticogastrostomy (HGS) combined with antegrade metal stenting (AS) can achieve longer stent patency and may be associated with fewer procedure-related adverse events (AEs) compared to EUS-HGS or EUS-AS alone 1 2 3 . However, EUS-guided hepaticoduodenostomy (HDS) with AS remains challenging 4 .…”

Section: Figmentioning

confidence: 99%

EUS-guided hepaticoduodenostomy combined with antegrade metal stenting using an ultrathin flexible delivery system

et al. 2021

View full text Add to dashboard Cite

EUS-guided antegrade procedures

Cited by 13 publications

References 46 publications

Moving scope technique improves technical success rate of device insertion during EUS-guided hepaticogastrostomy (with video)

Moving scope technique improves technical success rate of device insertion during EUS-guided hepaticogastrostomy (with video)

Society of Gastrointestinal Endoscopy of India Consensus Guidelines on Endoscopic Ultrasound-Guided Biliary Drainage: Part II (Technical Aspects)

EUS-guided hepaticoduodenostomy combined with antegrade metal stenting using an ultrathin flexible delivery system

Contact Info

Product

Resources

About