Safety and efficacy of ultra-tapered mechanical dilator for EUS-guided hepaticogastrostomy and pancreatic duct drainage compared with electrocautery dilator (with video)

Mitsuyoshi Honjo, Takao Itoi, Takayoshi Tsuchiya, Reina Tanaka, Ryosuke Tonozuka, Shuntaro Mukai, Atsushi Sofuni, Yuichi Nagakawa, Hidenori Iwasaki, Takanori Kanai

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background and Objectives: Successful tract dilation is one of the most important steps to accomplish EUS-guided drainage. Although mechanical dilation is safer than electrocautery dilation, no dedicated mechanical dilator (MD) is currently available. Thus, we developed a new ultra-tapered MD for EUS-guided drainage. This study aimed to evaluate the safety and usefulness of this novel MD. Patients and Methods: Consecutive patients who underwent EUS-guided hepaticogastrostomy (EUS-HGS) or EUS-guided pancreatic duct drainage (EUS-PD) at two centers were included in the study. Dilation of the needle tract was initially performed with a diathermic sheath or the ultra-tapered MD. Technical success and adverse events were assessed. Results: Sixty-four patients (mean age = 68.9 ± 13.8 years, 35 men) underwent EUS-HGS (49 patients) and EUS-PD (15 patients). Thirty-three patients were included in the cautery dilator (CD) group and 31 in the ultra-tapered MD group. Initial dilation of the puncture site was achieved in 95.3% (61/64): 97% (32/33) of the patients in the CD group and 93.3% (29/31) of the patients in the MD group (P > 0.05). Adverse events were observed in 14 patients: abdominal pain in 8 patients and bleeding in 6 patients at the puncture site. All bleedings occurred in the CD group and there was no patient in whom bleeding occurred after EUS intervention in the MD group (P = 0.04). Conclusion: The novel ultra-tapered MD designed for interventional EUS appears to be safe and useful as it reduced postprocedure bleeding with a high technical success rate compared with the conventional electrocautery dilator.

Original languageEnglish
Pages (from-to)376-382
Number of pages7
JournalEndoscopic Ultrasound
Volume7
Issue number6
DOIs
Publication statusPublished - 2018 Nov 1

Fingerprint

Electrocoagulation
Pancreatic Ducts
Drainage
Safety
Dilatation
Cautery
Hemorrhage
Punctures
Abdominal Pain
Needles

Keywords

  • Cautery dilator
  • EUS-guided hepaticogastrostomy
  • EUS-guided pancreatic duct drainage
  • Mechanical dilator

ASJC Scopus subject areas

  • Hepatology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Safety and efficacy of ultra-tapered mechanical dilator for EUS-guided hepaticogastrostomy and pancreatic duct drainage compared with electrocautery dilator (with video). / Honjo, Mitsuyoshi; Itoi, Takao; Tsuchiya, Takayoshi; Tanaka, Reina; Tonozuka, Ryosuke; Mukai, Shuntaro; Sofuni, Atsushi; Nagakawa, Yuichi; Iwasaki, Hidenori; Kanai, Takanori.

In: Endoscopic Ultrasound, Vol. 7, No. 6, 01.11.2018, p. 376-382.

Research output: Contribution to journalArticle

Honjo, Mitsuyoshi ; Itoi, Takao ; Tsuchiya, Takayoshi ; Tanaka, Reina ; Tonozuka, Ryosuke ; Mukai, Shuntaro ; Sofuni, Atsushi ; Nagakawa, Yuichi ; Iwasaki, Hidenori ; Kanai, Takanori. / Safety and efficacy of ultra-tapered mechanical dilator for EUS-guided hepaticogastrostomy and pancreatic duct drainage compared with electrocautery dilator (with video). In: Endoscopic Ultrasound. 2018 ; Vol. 7, No. 6. pp. 376-382.
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AU - Honjo, Mitsuyoshi

AU - Itoi, Takao

AU - Tsuchiya, Takayoshi

AU - Tanaka, Reina

AU - Tonozuka, Ryosuke

AU - Mukai, Shuntaro

AU - Sofuni, Atsushi

AU - Nagakawa, Yuichi

AU - Iwasaki, Hidenori

AU - Kanai, Takanori

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