Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;29(10):e88-e90.
doi: 10.1002/jhbp.904. Epub 2021 Feb 14.

EUS-guided hepaticogastrostomy for hepaticojejunostomy stricture using a 22G needle and a mechanical dilator (with video)

Takeshi Ogura  1 , Saori Ueno  1 , Atsushi Okuda  1 , Nobu Nishioka  1 , Kazuhide Higuchi  1
Affiliations

EUS-guided hepaticogastrostomy for hepaticojejunostomy stricture using a 22G needle and a mechanical dilator (with video)

Takeshi Ogura et al. J Hepatobiliary Pancreat Sci. 2022 Oct.

Abstract

EUS-guided biliary drainage (EUS-BD) has been indicated for benign biliary strictures. However, the intrahepatic bile duct is sometimes much narrower in benign biliary strictures. In this situation, puncture of the intrahepatic bile duct using a 19-G needle is sometimes challenging. Several reports have described attempts at EUS-BD using a 22-G needle, but fistula dilation with a 22-G needle is challenging because the 0.018-inch guidewire is not stiff enough to perform dilatation. Recently, a thin mechanical dilator has become available. After its insertion into the biliary tract, the 0.018-inch guidewire can be replaced with a 0.025-inch guidewire. We herein describe the technical procedure of EUS-guided hepaticogastrostomy using a 22-G needle with a thin mechanical dilator.

Keywords: ERCP; EUS; EUS-guided biliary drainage; EUS-guided hepaticogastrostomy; hepaticojejunostomy stricture.

PubMed Disclaimer

References

    1. Ogura T, Nishioka N, Yamada M, et al. Novel transluminal treatment protocol for hepaticojejunostomy stricture using covered self-expandable metal stent. Surg Endosc. 2021;35(1):209-15.
    1. Ogura T, Takenaka M, Shiomi H, et al. Long-term outcomes of EUS-guided transluminal stent deployment for benign biliary disease: multicenter clinical experience (with videos). Endosc Ultrasound. 2019;8:398-403.
    1. Mukai S, Tsuchiya T, Itoi T. Interventional endoscopic ultrasonography for benign biliary disease in patients with surgically altered anatomy. Curr Opin Gastroenterol. 2019;35:408-15.
    1. Nakai Y, Kogure H, Isayama H, et al. Endoscopic ultrasound-guided biliary drainage for benign biliary disease. Clin Endosc. 2019;52:212-9.
    1. Kanno Y, Ito K, Sakai T, et al. Novel combination of a 0.018-inch guidewire, dedicated thin dilator, and 22-gauge needle for EUS-guided hepaticogastrostomy. VideoGIE. 2020;5:355-8.

Publication types

LinkOut - more resources