| Featured Session 1 (JGES,JSGE,JSGS) |
| Fri. November 1st 9:00 - 11:00 Room 1: Kobe International Exhibition Hall No.2 Building Hall (North) |
| Adaptation of devices and techniques from gastrointestinal to pancreatobiliary fields | |||
| Haruka Toyonaga1, Tsuyoshi Hayashi1, Akio Katanuma1 | |||
| 1Center for Gastroenterology, Teine-Keijinkai Hospital | |||
|
|||
|
|||
| There has been remarkable development in devices and techniques in the gastrointestinal (GI) field, and were introduced to the pancreatobiliary (PB) field recently. Traction methods have gained attention during endoscopic submucosal dissection (ESD) for early GI cancers by facilitating proper counter-tension. In the PB filed, the use of traction can simplify cannulation by retracting folds and exposing papilla that are buried in the folds or diverticula. Gel immersion technique is employed as a substitute for water in various procedures, such as GI bleeding hemostasis, esophageal endoscopic ultrasound (EUS), and endoscopic mucosal resection (EMR). Inspired by these, we adapted the technique to biliary cannulation during persistent bleeding post-endoscopic sphincterotomy, EUS for ampullary tumor, and endoscopic papillectomy (EP). Tip-in technique, in which the snare tip is embedded in the mucosa to prevent slippage when performing EMR, was adapted to EP. In cases with periampullary diverticula, the Tip-in EP reduces the risks of perforation with large snare grasping and tumor residue with small grasping. A dual device channels and bending sections endoscope (M-scope, The GIF-2TQ260M) is commonly used for difficult-to-reach gastric cancer ESDs. Adapted in PB procedures following B-II reconstruction and post-EUS-guided hepaticogastrostomy (HGS) re-intervention, the M-scope simplifies reaching the papilla and accessing post-HGS, and enables more stable procedure. In conclusion, by learning from recent advancements in other fields, it is possible to adapt these techniques to PB endoscopy. |
|||
|
Index Term 1: Pancreatobiliary endoscopy Index Term 2: Devices and techniques |
|||
| Page Top | |||