Related Experiment Video
Updated: Mar 7, 2026
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Use of a screw dilator for pancreaticobiliary disease
Christina S Gainey1, Albert Manudhane1, Todd H Baron1
1Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Background And Aims:
Creating adequate tracts for device passage remains a challenge in ERCP and therapeutic EUS. We evaluated the technical success and safety of the Tornus ES (Asahi Intecc, Aichi, Japan) screw dilator for tract dilation during therapeutic EUS and ERCP.
Methods:
This retrospective, single-center study analyzed dilation of tracts during therapeutic EUS and ERCP using the Tornus ES from June 2025 to January 2026. Technical success was defined as successful stent placement across the dilated tract.
Results:
Twenty-one procedures (20 patients) were performed for biliary strictures, pancreatic duct obstructions, and bile leaks. Technical success was 95% (20 of 21 procedures). Interventions included ERCP (38%) and therapeutic EUS (62%). Adverse events occurred in 40% (8 of 20) of patients-none directly attributed to device failure.
Conclusions:
This first U.S. experience demonstrates that the Tornus ES screw dilator is an effective salvage tool during therapeutic EUS and ERCP for pancreaticobiliary disease.
