Double guidewire technique stabilization procedure for endoscopic ultrasound-guided hepaticogastrostomy involving modifying the guidewire angle at the insertion site

Fujii, Yuki; Kato, Hironari; Himei, Hitomi; Ueta, Eijiro; Ogawa, Taiji; Terasawa, Hiroyuki; Yamazaki, Tatsuhiro; Matsumoto, Kazuyuki; Horiguchi, Shigeru; Tsutsumi, Keisuke

doi:10.1007/s00464-022-09350-3

Cited by 8 publications

(8 citation statements)

References 27 publications

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“…Several efforts have been reported in this regard, including some that have evaluated the angle between the guidewire or the needle and the biliary tract during EUS-HGS. 20,21 Ohno et al. reported the feasibility and efficacy of EUS-HGS without dilation using a propensity score matching analysis.…”

Section: Discussionmentioning

confidence: 99%

“…reported the feasibility and efficacy of EUS-HGS without dilation using a propensity score matching analysis. 21 They did not include ERCP catheters among the dilation devices, and the focus was on the angle between the needle and the puncture site. A total of 74 patients who underwent successful EUS-HGS (dilation group, n = 35, non-dilation group, n = 34) were included According to the ROC curves, an angle of 90° had sensitivity of 51.4% and specificity of 94.6% for predicting the need for dilation.…”

Section: Discussionmentioning

confidence: 99%

“…Several efforts have been reported in this regard, including some that have evaluated the angle between the guidewire or the needle and the biliary tract during EUS-HGS. 21 They evaluated the association between the guidewire angle at the puncture site and successful ERCP catheter insertion. According to multivariate analysis using various factors, a guidewire angle at the insertion site of > 137° (p = 0.013) and the use of a double lumen cannula (p = 0.04) were significant factors associated with successful ERCP catheter insertion.…”

Section: Discussionmentioning

confidence: 99%

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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

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

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“…The most important factor for these difficulties is the risk of guidewire dislodgement due to the short length of the guidewire, which can be left in the pancreatic duct (PD). The double-guidewire technique for EUS-guided hepaticogastrostomy has been shown to be effective to stabilize an endoscope and prevent guidewire dislodgement 1 2 . Herein, we report that this technique is useful for EUS-PD.…”

Section: Figmentioning

confidence: 99%

A double-guidewire technique for endoscopic ultrasonography-guided pancreatic drainage after pancreaticoduodenectomy

et al. 2022

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“…ERCP contrast catheters are widely used for bile aspiration before dilation; however, the type of catheter that is preferable for EUS-HGS is unknown. The success rate of catheter insertion has been reported to be 65–84%, which might be considered suboptimal [ 11 , 12 ]. Therefore, an ERCP contrast catheter that can be easily inserted into the bile duct is highly desirable.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a Novel Tapered Contrast Catheter for Endoscopic Ultrasound-Guided Hepaticogastrostomy: A Multicenter Study

Niiya,

Sato,

Kaneko

et al. 2024

JCM

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Background: Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is an alternative for failed endoscopic retrograde cholangiopancreatography (ERCP), with current success rates of 65–84% considered suboptimal. A novel ERCP catheter (SHOREN, Kaneka Corporation, Osaka, Japan) with a tapered 3.3-French tip may facilitate smoother insertion, potentially improving outcomes. Methods: This retrospective analysis encompassed EUS-HGS procedures conducted from January 2021 to August 2023 at four institutions. The aim of this study was to compare the performance of conventional and novel ERCP contrast catheters regarding the success rate of single-attempt catheter insertion, failure rates, technical success rates, and incidence of adverse events. Results: The study included 48 patients; 26 underwent EUS-HGS using conventional catheters and 22 with the novel catheter. The novel catheter achieved higher success rates in single-attempt insertions (96.5% vs. 80.8%) and lower failure rates (4.6% vs. 7.7%). The occurrence of bile peritonitis was comparable between the two groups. Conclusions: The novel ERCP contrast catheter with a tapered tip appears to contribute to successful catheter insertion and is useful for EUS-HGS.

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Double guidewire technique stabilization procedure for endoscopic ultrasound-guided hepaticogastrostomy involving modifying the guidewire angle at the insertion site

Cited by 8 publications

References 27 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)

A double-guidewire technique for endoscopic ultrasonography-guided pancreatic drainage after pancreaticoduodenectomy

Efficacy of a Novel Tapered Contrast Catheter for Endoscopic Ultrasound-Guided Hepaticogastrostomy: A Multicenter Study

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