Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Endoscopy. 2017 Oct;49(10):983-988. doi: 10.1055/s-0043-113444. Epub 2017 Jul 21.
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. 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. 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 %. A novel hitch-and-ride catheter was feasible for biliary cannulation after EUS-RV.
内镜超声引导下会师（EUS-RV）术在经内镜逆行胰胆管造影术（ERCP）失败后，作为一种治疗选择，其应用越来越广泛。我们开发了一种新的“搭便车”胆管插管导管，以降低 EUS-RV 过程中导丝丢失的风险。
我们回顾性评估了 2011 年 6 月至 2016 年 5 月期间 EUS-RV 的安全性和技术成功率。比较了 EUS-RV 期间使用三种胆管插管方法（经导丝、顺导丝和搭便车）的安全性和技术成功率。共尝试了 30 例 EUS-RV，技术成功率为 93.3%，有两例失败（一例胆管穿刺，一例导丝插入）。在 28 例导丝成功通过后，尝试采用经导丝（n=13）、顺导丝（n=4）或搭便车（n=11）方法进行胆管插管。只有搭便车方法能够实现胆管插管，而不会导致导丝丢失或转换为其他方法。搭便车方法的插管时间（4 分钟）明显短于经导丝和顺导丝方法（分别为 9 分钟和 13 分钟）。EUS-RV 的不良事件发生率为 23.3%。一种新型的搭便车导管在内镜超声引导下会师后进行胆管插管是可行的。
