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. 2023 Mar;35(3):389-393.
doi: 10.1111/den.14447. Epub 2022 Oct 31.

Novel drill dilator facilitates endoscopic ultrasound-guided hepaticogastrostomy

Nozomi Okuno  1 , Kazuo Hara  1 , Shin Haba  1 , Takamichi Kuwahara  1 , Yasuhiro Kuraishi  1 , Takafumi Yanaidani  1 , Sho Ishikawa  1 , Tsukasa Yasuda  1 , Masanori Yamada  1 , Toshitaka Fukui  1
Affiliations

Novel drill dilator facilitates endoscopic ultrasound-guided hepaticogastrostomy

Nozomi Okuno et al. Dig Endosc. 2023 Mar.

Abstract

Tract dilation is one of the most difficult stages of endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), especially for beginners. To overcome this problem, we applied a special dedicated dilator. Herein, we retrospectively evaluate the safety and usefulness of a novel drill dilator in EUS-HGS. This single-center retrospective study included 20 consecutive patients who underwent EUS-HGS with a novel drill dilator. The tip is 0.77 mm, and it becomes 7F at 3 cm from tip. The track is dilated to 7F by simple clockwise rotation. The technical success rate of both initial tract dilation and stent placement was 20/20 (100%). No cases required additional dilation such as balloon or electric cautery. In 13/20 cases (65.0%), EUS-HGS was performed by beginner endoscopists. Median time required for dilation was 62.5 s (range, 30-144 s). Median procedure time was 13 min (range, 7-25 min). Early adverse events were two cases of mild fever. There was no bile leakage or bleeding. The novel drill dilator appears to be safe and useful for EUS-HGS. As it is not necessary to press the device strongly, there is no pushback during dilation and the scope position is stable. These characteristics facilitate EUS-HGS even for beginners. This device may enable the further development and increased dissemination of EUS intervention.

Keywords: EUS-guided biliary drainage; EUS-guided hepaticogastrostomy; biliary stricture; endoscopic ultrasonography; interventional EUS.

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References

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