EUS-guided rendezvous for difficult biliary cannulation using a standardized algorithm: a multicenter prospective pilot study (with videos).
作者： Takuji Iwashita , Ichiro Yasuda , Tsuyoshi Mukai , Keisuke Iwata , Nobuhiro Ando
DOI: 10.1016/J.GIE.2015.04.043
关键词:
摘要: Background and Aims Biliary cannulation is necessary in therapeutic ERCP for biliary disorders. EUS-guided rendezvous (EUS-RV) can salvage failed cannulation. Our aim was to determine the safety efficacy of EUS-RV by using a standardized algorithm with regard endoscope position prospective study. Methods attempted after 20 patients. In approach, extrahepatic bile duct (EHBD) preferentially from second portion duodenum (D2) followed additional approaches EHBD duodenal bulb (D1) or intrahepatic stomach, if necessary. A guidewire placed an antegrade fashion into duodenum. After placed, exchanged duodenoscope complete Results The accessed D2 10 patients, but D1 5 patients stomach 4 because no dilation tumor invasion at distal EHBD. remaining patient, puncture not due presence collateral vessels. successfully manipulated 80% patients: 100% (10/10) approach 66.7% (6/9) other approaches. overall success rate (16/20). Failed salvaged percutaneous 2 repeat 1 conservative management patient. Minor adverse events occurred 15% (3/20). Conclusions safe effective method. Using D2 may improve rates.
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