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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
EUS-guided biliary rendezvous using a short hydrophilic guidewire
Vinay Dhir1, Boon Eu Andrew Kwek, Suryaprakash Bhandari
1Institute of Advanced Endoscopy, Mumbai, India.
Journal of Interventional Gastroenterology
|May 16, 2012
Summary
Using a short hydrophilic guidewire for endoscopic retrograde cholangiopancreatography (ERCP) rendezvous is effective and safe. This technique simplifies biliary access in challenging cases.
Area of Science:
- Gastroenterology
- Interventional Endoscopy
- Biliary Interventions
Background:
- Endoscopic ultrasound (EUS)-guided biliary access via rendezvous technique often requires specialized long guidewires.
- Loss of guidewire during scope exchange is a known challenge in this procedure.
Purpose of the Study:
- To evaluate the efficacy and safety of utilizing a short hydrophilic guidewire in EUS-guided biliary rendezvous procedures.
- To determine if a short guidewire can be a viable alternative to long-wire systems.
Main Methods:
- A retrospective analysis of 15 patients undergoing EUS-guided biliary rendezvous with a short (260 cm) hydrophilic guidewire.
- Procedure involved EUS-guided puncture, anterograde guidewire placement across strictures/papilla, and subsequent retrograde ERCP.
Main Results:
- Successful EUS-guided biliary rendezvous was achieved in 14 out of 15 patients (93.3% success rate).
- One case failed due to a tight malignant biliary stricture.
- A single patient experienced manageable peri-choledochal bile tracking without requiring intervention.
Conclusions:
- The short hydrophilic guidewire system is a highly effective and safe method for EUS-guided biliary rendezvous.
- This approach serves as a valuable salvage technique for biliary cannulation, particularly when the papilla is accessible.
