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