Department of Gastroenterology, Aichi Cancer Center Hospital, Japan.
Intern Med. 2024 Oct 15;63(20):2723-2727. doi: 10.2169/internalmedicine.3207-23. Epub 2024 Feb 26.
Objective Adverse events such as bile leakage and bleeding are among the issues that need to be resolved in EUS-guided choledochoduodenostomy (EUS-CDS). To overcome this problem, we developed a new EUS-CDS technique using a 19-G Franseen needle without tract dilation. This study aimed to evaluate the safety and efficacy of the new EUS-CDS technique. Methods This single-center retrospective study included 20 consecutive patients who underwent EUS-CDS for primary drainage using a 19-G Franseen needle between March 2020 and May 2023. The primary endpoint was the technical success rate of EUS-CDS without tract dilation. Results The technical success rate of EUS-CDS was 20/20 (100%). None of the patients required any additional tract dilation, such as by using a balloon or electric cautery. The median procedure time was 7.8 [range, 3.2-19.4] min. No early adverse events were observed. Conclusion The 19-G Franseen needle appeared to have a sufficient dilatory effect during puncturing. This EUS-CDS technique appears to be safe and effective and has the advantages of no adverse events and it is also a simplified procedure, which suggests its potential for widespread use in primary drainage.
EUS 引导下胆总管十二指肠吻合术(EUS-CDS)需要解决胆汁漏和出血等不良事件的问题。为了解决这个问题,我们开发了一种新的 EUS-CDS 技术,使用 19-G Franseen 针而无需扩张通道。本研究旨在评估新的 EUS-CDS 技术的安全性和有效性。
这项单中心回顾性研究纳入了 20 例连续患者,他们在 2020 年 3 月至 2023 年 5 月期间使用 19-G Franseen 针进行原发性引流 EUS-CDS。主要终点是不扩张通道的 EUS-CDS 的技术成功率。
EUS-CDS 的技术成功率为 20/20(100%)。没有患者需要任何额外的通道扩张,如使用球囊或电灼。中位手术时间为 7.8[范围,3.2-19.4]分钟。没有观察到早期不良事件。
19-G Franseen 针在穿刺时似乎具有足够的扩张效果。这种 EUS-CDS 技术似乎是安全有效的,具有无不良事件的优点,并且还简化了操作流程,因此有可能在原发性引流中广泛使用。