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. 2024 May 11;13(10):2840.
doi: 10.3390/jcm13102840.

Dedicated Echoendoscope for Interventional Endoscopic Ultrasound: Comparison with a Conventional Echoendoscope

Toshio Fujisawa  1 , Shigeto Ishii  1 , Yousuke Nakai  2   3 , Hirofumi Kogure  4 , Ko Tomishima  1 , Yusuke Takasaki  1 , Koichi Ito  1 , Sho Takahashi  1 , Akinori Suzuki  1 , Hiroyuki Isayama  1
Affiliations

Dedicated Echoendoscope for Interventional Endoscopic Ultrasound: Comparison with a Conventional Echoendoscope

Toshio Fujisawa et al. J Clin Med. .

Abstract

Background/Objective: Interventional endoscopic ultrasound (I-EUS) is technically difficult and has risks of severe adverse events due to the scarcity of dedicated endoscopes and tools. A new EUS scope was developed for I-EUS and was modified to increase the puncture range, reduce the blind area, and overcome guidewire difficulties. We evaluated the usefulness and safety of a new EUS scope compared to a conventional EUS scope. Methods: All I-EUS procedures were performed at Juntendo University Hospital from April 2020 to April 2022. The primary outcomes included the procedure time and fluoroscopy time. The secondary outcomes included the technical success rate and the rates of procedure-related adverse events. Clinical data were retrospectively reviewed and statistically analyzed between the new and conventional EUS scopes. Results: In total, 143 procedures in 120 patients were analyzed. The procedure time was significantly shorter with the new EUS scope, but the fluoroscopy time was not different. Among the patients only undergoing EUS-guided biliary drainage (EUS-BD), 79 procedures in 74 patients were analyzed. Both the procedure time and fluoroscopy time were significantly shorter with the new EUS scope. Multivariate analysis revealed that a new EUS scope and use of covered metal stents could reduce the fluoroscopy time. The technical success rate and the adverse event rate were not significantly different between the total I-EUS and the EUS-BD only groups. However, the conventional scope showed stent deviation during stent placement, which did not happen with the new scope. Conclusions: The new EUS scope reduced procedure time for total I-EUS and fluoroscopy time for EUS-BD compared to a conventional EUS scope because of the improvement suitable for I-EUS.

Keywords: EUS-guided biliary drainage (EUS-BD); adverse events; endoscopic ultrasound (EUS); fluoroscopy time; interventional EUS.

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Conflict of interest statement

Nakai received a research grant from Fujifilm Corporation, and lecture fees from Fujifilm Corporation, Olympus Corporation, and Boston Scientific Japan. Isayama received research grants from Fujifilm Corporation and Boston Scientific Japan, and lecture fees from Fujifilm Corporation, Century Medical Corporation, and Boston Scientific Japan.

Figures

Figure 1
Figure 1
Performance of a conventional scope (EG-580 UT) and the new scope (EG-740 UT). (A) The radius of curvature of the flexible tip of the scope was decreased from 27.9° to 25.0°. This improvement made the scope more nimble. (B) The strength of the forceps elevator was increased. In an experiment using a 0.025-inch guidewire, the elevation angle increased from 35.2° to 76.7°. (C). The CCD camera (yellow arrows) was behind the forceps channel in the new scope. Stent deployment was easily observed.
Figure 2
Figure 2
The flow chart of the patient selections and examinations regarding two cohorts: entire I-EUS and limited EUS-BD.
See this image and copyright information in PMC

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References

    1. Dhir V., Isayama H., Itoi T., Almadi M., Siripun A., Teoh A.Y.B., Ho K.Y. Endoscopic ultrasonography-guided biliary and pancreatic duct interventions. Dig. Endosc. 2017;29:472–485. doi: 10.1111/den.12818. - DOI - PubMed
    1. Gopakumar H., Singh R.R., Revanur V., Kandula R., Puli S.R. Endoscopic Ultrasound–Guided vs Endoscopic Retrograde Cholangiopancreatography–Guided Biliary Drainage as Primary Approach to Malignant Distal Biliary Obstruction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Am. J. Gastroenterol. 2024 doi: 10.14309/ajg.0000000000002736. Online ahead of print . - DOI - PubMed
    1. Spadaccini M., Giacchetto C.M., Fiacca M., Colombo M., Andreozzi M., Carrara S., Maselli R., Saccà F., De Marco A., Franchellucci G., et al. Endoscopic Biliary Drainage in Surgically Altered Anatomy. Diagnostics. 2023;13:3623. doi: 10.3390/diagnostics13243623. - DOI - PMC - PubMed
    1. Isayama H., Nakai Y., Itoi T., Yasuda I., Kawakami H., Ryozawa S., Kitano M., Irisawa A., Katanuma A., Hara K., et al. Clinical practice guidelines for safe performance of endoscopic ultrasound/ultrasonography-guided biliary drainage: 2018. J. Hepato-Biliary-Pancreatic Sci. 2019;26:249–269. doi: 10.1002/jhbp.631. - DOI - PMC - PubMed
    1. Giri S., Mohan B.P., Jearth V., Kale A., Angadi S., Afzalpurkar S., Harindranath S., Sundaram S. Adverse events with EUS-guided biliary drainage: A systematic review and meta-analysis. Gastrointest. Endosc. 2023;98:515–523.e18. doi: 10.1016/j.gie.2023.06.055. - DOI - PubMed

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