Background and aim
To insert the metal stent delivery system (8.5Fr) during interventional EUS, several dilation steps are needed, and this may be related to increased bile leakage from a fistula. TThere have been no definitive studies of dilation force. The aim of the present study was to evaluate dilation force during I-EUS using several dilation devices.
Method
In the present study, seven dilation devices were evaluated including bougie dilators such as straight-shaped dilator (the ES dilator, Soehendra dilator, a standard ERCP catheter) and screw-shaped dilator (Tornus ES, Soehendra stent retriever), and 4mm-balloon catheter (REN biliary balloon catheter, Hurricane RX). The diameter of each dilators and dilation force was measured.
Result
Of the bougie dilators, the dilation force of the ES dilator was the highest (0.908 ± 0.035 kg). Of the balloon catheters, the dilation force of the Hurricane RX (3.261 ± 0.024 kg) was slightly higher than that of the REN (3.159 ± 0.072 kg). Of the bougie dilators, although the diameter of the ES dilator was not larger than that of the Tornus ES the dilation force was stronger. Similarly, the diameter of the Soehendra stent retriever was greater than that of the ERCP catheter or Soehendra dilator, and the dilation force was lower.
In conclusion, compared with bougie dilators, balloon catheters have stronger dilation force according to our experimental study. The present results should be evaluated in clinical trials.