Liver impaction technique improves technical success rate of guidewire insertion during EUS-guided hepaticogastrostomy (with video).

ERCP EUS-HGS EUS-guided hepaticogastrostomy biliary drainage endoscopic ultrasound-guided biliary drainage

Journal

Therapeutic advances in gastroenterology
ISSN: 1756-283X
Titre abrégé: Therap Adv Gastroenterol
Pays: England
ID NLM: 101478893

Informations de publication

Date de publication:
2023
Historique:
received: 29 04 2023
accepted: 20 06 2023
medline: 5 9 2023
pubmed: 5 9 2023
entrez: 5 9 2023
Statut: epublish

Résumé

If the guidewire becomes kinked by the needle, guidewire manipulation may be difficult, and can cause complications such as guidewire shearing or injury during endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS). To overcome this matter, we have previously described a technical tip for preventing guidewire injury, termed 'liver impaction technique'. However, its technical feasibility has been not reported in the setting of a large patient cohort. The aim of study was to evaluate the clinical usefulness of the liver impaction technique during EUS-HGS. Retrospective, single-center study. This retrospective study included consecutive patients who underwent EUS-HGS between April 2018 and September 2022. The primary outcome of this study was the technical success rate of guidewire insertion using the liver impaction technique. A total of 166 patients were enrolled in this study. Initial successful guidewire insertion without using liver impaction technique was obtained in 108 patients (65.1%). Among 58 patients in whom guidewire insertion failed initially, guidewire advancement into the periphery of the bile duct was observed in 32 patients (55.2%) and into a non-interest bile duct branch was observed in 26 patients (44.8%). Liver impaction technique contributed to increasing the technical success rate of guidewire insertion from 65.1% to 95.8%. Overall, adverse events were observed in 12 patients (7.2%; bile peritonitis In conclusion, the liver impaction technique may be helpful during EUS-HGS to obtain successful guidewire insertion into the biliary tract of interest.

Sections du résumé

Background UNASSIGNED
If the guidewire becomes kinked by the needle, guidewire manipulation may be difficult, and can cause complications such as guidewire shearing or injury during endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS). To overcome this matter, we have previously described a technical tip for preventing guidewire injury, termed 'liver impaction technique'. However, its technical feasibility has been not reported in the setting of a large patient cohort.
Objectives UNASSIGNED
The aim of study was to evaluate the clinical usefulness of the liver impaction technique during EUS-HGS.
Design UNASSIGNED
Retrospective, single-center study.
Methods UNASSIGNED
This retrospective study included consecutive patients who underwent EUS-HGS between April 2018 and September 2022. The primary outcome of this study was the technical success rate of guidewire insertion using the liver impaction technique.
Results UNASSIGNED
A total of 166 patients were enrolled in this study. Initial successful guidewire insertion without using liver impaction technique was obtained in 108 patients (65.1%). Among 58 patients in whom guidewire insertion failed initially, guidewire advancement into the periphery of the bile duct was observed in 32 patients (55.2%) and into a non-interest bile duct branch was observed in 26 patients (44.8%). Liver impaction technique contributed to increasing the technical success rate of guidewire insertion from 65.1% to 95.8%. Overall, adverse events were observed in 12 patients (7.2%; bile peritonitis
Conclusions UNASSIGNED
In conclusion, the liver impaction technique may be helpful during EUS-HGS to obtain successful guidewire insertion into the biliary tract of interest.

Identifiants

pubmed: 37667804
doi: 10.1177/17562848231188562
pii: 10.1177_17562848231188562
pmc: PMC10475223
doi:

Types de publication

Journal Article

Langues

eng

Pagination

17562848231188562

Informations de copyright

© The Author(s), 2023.

Déclaration de conflit d'intérêts

The authors declare that there is no conflict of interest.

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Auteurs

Junichi Nakamura (J)

2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.

Takeshi Ogura (T)

Endoscopy Center, Osaka Medical and Pharmaceutical University, 2-7 Daigakuchou, Takatsukishi, Osaka 569-8686, Japan.
2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, 1-1 Daigakuchou, Takatsuki, Osaka 569-0801, Japan.

Saori Ueno (S)

2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.

Atsushi Okuda (A)

2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.

Nobu Nishioka (N)

2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.

Yuki Uba (Y)

2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.

Mitsuki Tomita (M)

2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.

Kimi Bessho (K)

2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.

Nobuhiro Hattori (N)

2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.

Hiroki Nishikawa (H)

2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.

Classifications MeSH