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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(03): E487-E489
DOI: 10.1055/a-1339-0690
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Water-filled technique for therapeutic pancreato-biliary EUS in patients with surgically altered anatomy

Benedetto Mangiavillano
1   Gastrointestinal Endoscopy Unit – Humanitas Mater Domini – Castellanza, Italy
2   Humanitas University, Rozzano, Italy
,
Silvia Carrara
3   Digestive Endoscopy Unit, Humanitas Clinical and Research Center, Rozzano, Italy
,
Leonardo H. Eusebi
4   Endoscopy Unit, Department of Medical and Surgical Sciences, Sant’Orsola University Hospital, Bologna, Italy
,
Franceasco Auriemma
1   Gastrointestinal Endoscopy Unit – Humanitas Mater Domini – Castellanza, Italy
,
Mario Bianchetti
1   Gastrointestinal Endoscopy Unit – Humanitas Mater Domini – Castellanza, Italy
,
Alessandro Repici
2   Humanitas University, Rozzano, Italy
3   Digestive Endoscopy Unit, Humanitas Clinical and Research Center, Rozzano, Italy
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Abstract

One of the main challenges encountered by endosonographers is performing diagnostic and interventional pancreato-biliary endoscopic ultrasound (EUS) procedures in the presence of surgically altered upper gastrointestinal anatomy. We describe the water-filled technique (WFT) for EUS examination and treatment of the pancreato-biliary region in patients with surgically altered upper gastrointestinal anatomy. Using the WFT, the scope is advanced up to the gastro-jejunal anastomosis and, after placing the tip of the scope 2 cm beyond it, enlargement of the jejunal lumen is obtained by water instillation of the jejunal loop. An enlargement of more than 1.5 cm allows advancement of the tip of the scope under EUSguidance up to the duodenum, in a retrograde way. The WFT is useful for reaching the ampullary area and performing diagnostic and therapeutic EUS in patients with surgically altered anatomy. The technique is also reproducible and can be easily used by endoscopists who regularly perform EUS.



Publication History

Received: 17 June 2020

Accepted: 28 September 2020

Article published online:
22 February 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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