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

doi:10.1055/s-0043-113444

Endoscopy, Table of Contents

Endoscopy 2017; 49(10): 983-988
DOI: 10.1055/s-0043-113444

Innovations and brief communications

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

Authors

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

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.

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References

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