Endoscopy 2017; 49(10): 983-988
DOI: 10.1055/s-0043-113444
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

A novel “hitch-and-ride” deep biliary cannulation method during rendezvous endoscopic ultrasound-guided ERCP technique

Yousuke Nakai
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
,
Hiroyuki Isayama
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
,
Saburo Matsubara
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
,
Hirofumi Kogure
,
Suguru Mizuno
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
,
Tsuyoshi Hamada
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
,
Naminatsu Takahara
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
,
Tomoka Nakamura
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
,
Tatsuya Sato
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
,
Tsuyoshi Takeda
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
,
Ryunosuke Hakuta
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
,
Kazunaga Ishigaki
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
,
Kei Saito
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
,
Minoru Tada
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
,
Kazuhiko Koike
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

submitted 31 January 2017

accepted after revision 14 May 2017

Publication Date:
21 July 2017 (eFirst)

Abstract

Background and study aim Endoscopic ultrasound-guided rendezvous (EUS-RV) is increasingly reported as a treatment option after failed endoscopic retrograde cholangiopancreatography. We developed a novel “hitch-and-ride” catheter for biliary cannulation to reduce the risk of guidewire loss during EUS-RV.

Patients and methods We retrospectively evaluated safety and technical success of EUS-RV between June 2011 and May 2016. Biliary cannulation during EUS-RV using three methods – over-the-wire, along-the-wire, and hitch-and-ride – were compared.

Results A total of 30 EUS-RVs were attempted and the technical success rate was 93.3 %, with two failures (one bile duct puncture and one guidewire insertion). After 28 cases of successful guidewire passage, cannulation was attempted by the over-the-wire (n = 13), along-the-wire (n = 4) or hitch-and-ride (n = 11) method. Only the hitch-and-ride method achieved biliary cannulation without guidewire loss or conversion to the other methods. Time to cannulation was shorter with the hitch-and-ride method (4 minutes) than with over-the-wire and along-the-wire methods (9 and 13 minutes, respectively). The adverse event rate of EUS-RV was 23.3 %.

Conclusion A novel hitch-and-ride catheter was feasible for biliary cannulation after EUS-RV.