2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
J Hepatobiliary Pancreat Sci. 2022 Oct;29(10):e88-e90. doi: 10.1002/jhbp.904. Epub 2021 Feb 14.
EUS-guided biliary drainage (EUS-BD) has been indicated for benign biliary strictures. However, the intrahepatic bile duct is sometimes much narrower in benign biliary strictures. In this situation, puncture of the intrahepatic bile duct using a 19-G needle is sometimes challenging. Several reports have described attempts at EUS-BD using a 22-G needle, but fistula dilation with a 22-G needle is challenging because the 0.018-inch guidewire is not stiff enough to perform dilatation. Recently, a thin mechanical dilator has become available. After its insertion into the biliary tract, the 0.018-inch guidewire can be replaced with a 0.025-inch guidewire. We herein describe the technical procedure of EUS-guided hepaticogastrostomy using a 22-G needle with a thin mechanical dilator.
EUS 引导下胆道引流（EUS-BD）已被用于治疗良性胆道狭窄。然而，在良性胆道狭窄中，肝内胆管有时要窄得多。在这种情况下，使用 19-G 针穿刺肝内胆管有时具有挑战性。有几份报告描述了使用 22-G 针进行 EUS-BD 的尝试，但使用 22-G 针进行瘘管扩张具有挑战性，因为 0.018 英寸的导丝不够硬，无法进行扩张。最近，一种细的机械扩张器已经问世。将其插入胆道后，可以用 0.025 英寸的导丝替换 0.018 英寸的导丝。我们在此描述了使用带有细机械扩张器的 22-G 针进行 EUS 引导下经皮经肝胆管造口术的技术过程。
