Usefulness of a laser-cut covered metal stent with a 7F delivery sheath in endoscopic ultrasound-guided biliary drainage without fistula dilation

Abstract Background and study aims  Recently, the utility of endoscopic ultrasound-guided intervention without fistula dilation (EUS-IV WoD) has been reported to prevent adverse events. We clinically evaluated cases in which EUS-IV WoD was attempted using a novel self-expandable metallic stent (SEMS...

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Published in:Endoscopy International Open 2023-01, Vol.11 (1), p.E97-E104
Main Authors: Takeshita, Kotaro, Hijioka, Susumu, Nagashio, Yoshikuni, Maruki, Yuta, Ohba, Akihiro, Kawasaki, Yuki, Hisada, Yuya, Yoshinari, Motohiro, Harai, Shota, Kitamura, Hidetoshi, Koga, Takehiko, Maehara, Kosuke, Murashima, Yumi, Yamada, Natsumi, Okada, Mao, Takasaki, Tetsuro, Agarie, Daiki, Hara, Hidenobu, Hagiwara, Yuya, Okamoto, Kohei, Yamashige, Daiki, Kondo, Shunsuke, Morizane, Chigusa, Ueno, Hideki, Saito, Yutaka, Okusaka, Takuji
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Language:English
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Summary:Abstract Background and study aims  Recently, the utility of endoscopic ultrasound-guided intervention without fistula dilation (EUS-IV WoD) has been reported to prevent adverse events. We clinically evaluated cases in which EUS-IV WoD was attempted using a novel self-expandable metallic stent (SEMS); this is a fully covered, laser-cut SEMS that has a tapered and stiff tip specifically designed for a 0.025-inch guidewire and a relatively thin, 7F delivery system. Patients and methods  We retrospectively evaluated cases wherein EUS-IV WoD was attempted using the novel SEMS between March and December 2021. Results  Treatment of 11 patients by EUS-IV WoD with the novel SEMS was attempted. The technical success rate for EUS-IV was 100 % and the clinical success rate was 100 %; the success rate for EUS-IV WoD was 72.8 %. Of these, the procedural success rate for EUS-IV WoD was 100 % in EUS-biliary drainage (BD) and 57.1 % in non-EUS-BD. Early adverse events were observed in 27.3 % of patients (3/11): mild abdominal pain in two patients and moderate bleeding in one patient. The abdominal pain cases were both cases of EUS-IV WoD failure and required fistula dilation. Conclusions  The novel stent may be useful for EUS-IV WoD, especially in EUS-BD.
ISSN:2364-3722
2196-9736
DOI:10.1055/a-1997-9149