Prospective evaluation of a treatment algorithm with enhanced guidewire manipulation protocol for EUS-guided biliary drainage after failed ERCP (with video)

Park, Do Hyun; Jeong, Seung Uk; Lee, Byung Uk; Lee, Sang Soo; Seo, Dong–Wan; Lee, Sung Koo; Kim, Myung–Hwan

doi:10.1016/j.gie.2013.01.042

Cited by 176 publications

(163 citation statements)

References 27 publications

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“…Comparable results were obtained in a separate review [273]. Lower adverse events are reported by experienced centers [265,279,280,295]. In one study complications occurred in 15/95 ESC-D (15.7 %), with a single intraperitoneal stent migration in advanced tumor disease responsible for a 1.1 % mortality rate [265].…”

Section: Adverse Eventsmentioning

confidence: 69%

“…A 19G needle allows passage of a 0.035" guidewire, whereas a 22G needle allows a 0.018" guidewire [18,19]. The selection of the approach route is the most important factor for practical guidewire maneuvering and manipulation in the desired direction [272,279,280]. Following stylet removal, bile is aspirated and contrast medium is injected to obtain a cholangiogram.…”

Section: Recommendation 26mentioning

confidence: 99%

“…Techniques were not standardized, and low patient numbers per center may have contributed with male gender and technical failure as independent predictors of morbidity [289]. Comparative analysis of two prospective studies suggests that the rate of adverse events may be reduced by a defined algorithm of guidewire manipulation, aiming at replacing EUS-guided retrograde transluminal drainage by rendezvous techniques or anterograde internal approach [264,280]. An evaluation of risk factors for adverse events reported no significant differences between plastic and metal stents [264].…”

Section: Adverse Eventsmentioning

confidence: 99%

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2016

Ultraschall in Med

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Section: Adverse Eventsmentioning

confidence: 69%

Section: Recommendation 26mentioning

confidence: 99%

Section: Adverse Eventsmentioning

confidence: 99%

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2016

Ultraschall in Med

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“…However, the complication rates for these more advanced techniques are much higher than for standard procedures (23). In few centers, EUSguided biliary drainage has been introduced as a viable alternative after failed ERC access (24,25). Although this approach requires further standardization and clinical trial validation.…”

Section: Endoscopic and Surgical Treatmentmentioning

confidence: 99%

Controversy and progress for treatment of acute cholangitis after Tokyo Guidelines (TG13)

Sun

Zhu

et al. 2016

BST

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“…During endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), it is necessary to dilate the fistula [1]. Graded dilation with a 4-Fr cannula and 6-and 7-Fr bougie dilators is relatively easily performed, and this stepwise procedure appears to be safe [2].…”

mentioning

confidence: 99%

Endoscopic ultrasound-guided biliary drainage with a novel fine-gauge balloon catheter: one-step placement technique

et al. 2015

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During endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), it is necessary to dilate the fistula [1]. Graded dilation with a 4-Fr cannula and 6-and 7-Fr bougie dilators is relatively easily performed, and this stepwise procedure appears to be safe [2]. On the other hand, the use of a needle knife for fistula dilation in endoscopic ultrasound-guided biliary drainage (EUS-BD) may be associated with post-procedural adverse events [3]. These procedures have the potential to cause bile leakage because only the guidewire is placed between the bile duct and intestine across the abdominal cavity during the exchange of devices. There is a great need for a simplified technique to avoid such adverse events. A novel balloon catheter (ZARA; Century Medical, Tokyo, Japan) has two unique characteristics (• " Fig. 1). First, the tip of the balloon catheter is only 3 Fr in diameter and tapered. Second, the surface of the balloon catheter is rough. Therefore, the device is easily inserted following puncture with a 19-gauge needle, and during balloon dilation, the characteristics of the surface may be of clinical benefit in preventing malposition of the dilation site. An 80-year-old man was admitted because of vomiting and obstructive jaundice due to unresectable pancreatic cancer, which was obstructing the duodenum. First, we performed duodenal stenting. Next, we punctured the intrahepatic bile duct with a 19-gauge fine-needle aspiration needle and inserted a 0.025-inch stiff guidewire. The novel balloon catheter could then be smoothly inserted into the duodenum across the stricture site and duodenal stent. We dilated the stricture and duodenal stent to place the metallic stent, after which we used the novel balloon catheter to dilate the intrahepatic bile duct (• " Fig. 2) and stomach wall (• " Fig. 3). A metallic stent delivery system was then inserted in antegrade fashion and successfully placed at the lower bile duct. Finally, we performed the EUS-HGS (• " Fig. 4). No adverse events occurred.

show abstract

Prospective evaluation of a treatment algorithm with enhanced guidewire manipulation protocol for EUS-guided biliary drainage after failed ERCP (with video)

Cited by 176 publications

References 27 publications

Untitled

Untitled

Controversy and progress for treatment of acute cholangitis after Tokyo Guidelines (TG13)

Endoscopic ultrasound-guided biliary drainage with a novel fine-gauge balloon catheter: one-step placement technique

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