Strategic International Session2(JGES・JSGE・JSGS)
Fri. November 3rd   9:00 - 12:00   Room 11: Portopia Hotel South Wing Topaz
ST2-5_E
 Technical tips to improve technical success rate of EUS-guided drainage
Takeshi Ogura1, Nobu Nishioka2, Hiroki Nishikawa2
1Endoscopic Center, Osaka Medical and Pharmaceutical University Hospital, 22nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University
Background: EUS-PD or BD have emerged as alternative drainage techniques for failed ERCP. To improve technical success rate, various techniques are applied in our hospital. We herein describe the technical feasibility and safety of physician-controlled parenchyma impaction and moving scope techniques (MST).
Patients and Method: Technical success of the physician-controlled parenchyma impaction technique was defined as successful guidewire advancement without guidewire shearing or injury. Technical success of the moving scope technique was defined as an increase in angle between the duct and the guidewire after application of the MST, compared with the angle prior to application of MST.
Results: 166 patients who underwent EUS-BD and 21 patients who underwent EUS-PD were enrolled. Among 68 patients who were failed initial guidewire insertion, guidewire insertion was successfully performed in 61 patients after application of physician-controlled parenchyma impaction technique. Among 180 patients who were successfully guidewire deployment, initial dilation device insertion was failed in 28 EUS-BD patients and 12 EUS-PD patients. We attempted the MST in all 28 of EUS-BD patients, which improved the mean angle between the intrahepatic bile duct and the guidewire to 141.0 from 128.6 and resulted in a technical success rate of 100% (28/28). Technical success rate of EUS-PD was obtained in all patients after MST.
Conclusions: Our technique might be helpful.
Index Term 1: EUS-BD
Index Term 2: EUS-HGS
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