UEG's content platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

Re-live UEG Week 2026 on Gutflix Gut Guide online What's new on Gutflix

Trending on Gutflix

Rate for better recommendations!

Your feedback helps us show you more of what you like and less of what you dislike!

More of this!

We will show you more similar content.

Not for me!

We won't suggest this again.

Bookmark!

Save this content for later!

New to myUEG? Create an account! Log In with myUEG account

UEG Poster

Standard Poster

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

A NOVEL DRILL AS THE TRACT DILATION TECHNIQUE DURING EUS-GUIDED BILIARY DRAINAGE BY NON-EXPERT HANDS (WITH VIDEO)

Masahiro Yamamaura 1, Takeshi Ogura 2, Saori Ueno 1, Atsushi Okuda 1, Nobu Nishioka 1, NOBUHIRO HATTORI 1, Kimi Bessho 1, Hiroki Nishikawa 1

Affiliations

1 Osaka Medical and Pharmaceutical University, Osaka, Japan

2 Osaka Medical and Pharmacetuical University, Oasaka, Japan

Summary

AI Generated

A retrospective comparison of a novel drill dilator versus balloon catheter for tract dilation during EUS-guided hepaticogastrostomy found both achieved high initial dilation success rates, but the drill dilator required additional dilation in most cases to allow stent delivery system insertion.

49 patients underwent EUS-HGS with SEMS between October 2021 and October 2022, with 19 receiving drill dilator and 30 receiving balloon catheter for initial tract dilation
Initial tract dilation was successful in 100% of drill dilator cases and 97% of balloon catheter cases, a difference that was not statistically significant
Additional tract dilation was needed to insert the 8.5Fr stent delivery system in 73.7% of drill dilator cases, while all balloon catheter cases achieved successful insertion without additional dilation
Drill dilator procedures were performed mainly by non-expert operators while balloon catheter procedures were predominantly performed by experts, representing a significant difference in operator experience between groups
The authors conclude that balloon dilation should be attempted first when deploying a dedicated metal stent using an 8.5Fr delivery system

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

In the case that tract dilation fails using the initially selected dilation device during EUS-guided hepaticogastrostomy (HGS), it should be re-attempted using another device. However, switching the device has the disadvantages of prolonged procedure time and sudden loss of the correct axis, and it is therefore highly desirable that the initial tract dilation is successful. Recently, a novel drill dilator has recently become available in Japan. However, comparison study between this device and other has been not reported as initial dilation technique. Here we describe the technical feasibility of this device for use during EUS-HGS, and compared with balloon catheter.

Aims & Methods

This retrospective study included patients who underwent EUS-HGS using SEMS between October 2021 and October 2022. Patients who developed bleeding associated with EST were enrolled. Excluded from the study were patients who underwent EUS-HGS using a plastic stent or stent deployment without tract dilation.

Results

A total of 49 patients were enrolled, of whom 19 underwent EUS-HGS using the drill dilator and 30 underwent EUS-HGS using a balloon catheter. EUS-HGS using the drill dilator initially was performed mainly by non-expert hands (n=19), whereas non-expert hands performed few procedures in the balloon catheter group (n=2) (P<0.0001). The initial tract dilation was successful in all patients in the drill dilator group (19/19, 100%) and in 29/30 (97%) in the balloon catheter group (P=0.4214). However, to insert stent delivery system, additional tract dilation was needed in 73.7% (14/19) of the drill dilator group. On the other hand, stent delivery system insertion was successful in all patients of the balloon catheter group.

Conclusion

The novel drill dilator shows promise for initial dilation during EUS-BD. However, balloon dilation technique should be attempted first when deploying a dedicated metal stent using an 8.5Fr stent delivery system.

Conference

UEG Week Copenhagen 2023

Topics

Hepatobiliary

Submission format

Abstract

Session

PP 07 Liver & biliary (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

More Like This:

EUS-guided biliary drainage (Complete Session)

Video case: EUS-guided biliary drainage

Manuel Pérez-Miranda

TRANSLUMINAL ANTEGRADE PIECEMEAL DILATION TECHNIQUE FOR HEPATICOJEJUNOSTOMY STRICTURE WITH CHOLANGIOSCOPIC EVALUATION

Hiroki Nishikawa

PROPENSITY SCORE MATCHING ANALYSIS FOR CLINICAL IMPACT OF BRAIDED- VERSUS LASER-CUT-TYPE COVERED SELF-EXPANDABLE METAL STENTS FOR EUS-GUIDED HEPATICOGASTROSTOMY

Hiroki Nishikawa

Video case: Optimising techniques for biliary cannulation

Marianna Arvanitakis

CLINICAL EVALUATION OF 22G NEEDLE WITH NOVEL 0.018-INCH GUIDEWIRE AND NOVEL DILATION DEVICES DURING EUS-GUIDED TRANSHEPATIC BILIARY DRAINAGE

Hiroki Nishikawa

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

EUS-guided biliary drainage (Complete Session)

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.