Endoscopy 2021; 53(09): 922-926
DOI: 10.1055/a-1301-1526
Innovations and brief communications

A novel electrocautery-enhanced delivery system for one-step endoscopic ultrasound-guided drainage of the gallbladder and bile duct using a lumen-apposing metal stent: a feasibility study

Hae Won Yoo*
1  Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Republic of Korea
,
Jong Ho Moon
1  Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Republic of Korea
,
Seok Jung Jo*
1  Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Republic of Korea
,
Yun Nah Lee
1  Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Republic of Korea
,
Jae Keun Park
1  Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Republic of Korea
,
Tae Hoon Lee
2  Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Cheonan, Republic of Korea
,
Sang-Woo Cha
3  Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Seoul, Republic of Korea
,
Young Deok Cho
3  Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Seoul, Republic of Korea
,
Sang-Heum Park
2  Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Cheonan, Republic of Korea
,
Se Ik Park
4  Department of Research and Development, Taewoong Medical, Ilsan, Republic of Korea
,
Seok Jeong
5  Digestive Disease Center and Research Institute, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
,
Don Haeng Lee
5  Digestive Disease Center and Research Institute, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
› Author Affiliations

Abstract

Background The use of a lumen-apposing metal stent (LAMS) capable of one-step endoscopic ultrasound-guided transmural drainage (EUS-TD) can increase the effectiveness of the procedure. We evaluated the newly developed electrocautery-enhanced (EC) delivery system with a LAMS for one-step EUS-guided gallbladder drainage (EUS-GBD) or choledochoduodenostomy (EUS-CDS).

Methods In the animal experiment, an EC-LAMS was advanced into the gallbladder without prior tract dilation in four pigs. A conventional LAMS was inserted in another four pigs as a control group. After the animal experiment, 17 patients underwent EUS-TD using the EC-LAMS (EUS-GBD in 10 patients, EUS-CDS in 7). The primary outcome was the technical success rate.

Results In the animal study, the mean procedure time was significantly shorter in the EC-LAMS group than in the conventional LAMS group. In the human study, the overall technical success rate was 94.1 %, with one EUS-GBD failure. The clinical success rate was 100 %. The overall adverse event rate was 17.6 %.

Conclusions One-step EUS-GBD or EUS-CDS using the novel EC-LAMS is a feasible approach that achieves a high success rate and maintains safety.

* Contributed equally.


Tab. 1s, Figs. 1s – 3s



Publication History

Received: 29 May 2020

Accepted: 28 September 2020

Publication Date:
17 December 2020 (online)

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