A novel "hitch-and-ride" deep biliary cannulation method during rendezvous endoscopic ultrasound-guided ERCP technique

Endoscopy. 2017 Oct;49(10):983-988. doi: 10.1055/s-0043-113444. Epub 2017 Jul 21.

Abstract

Background and study aim 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. Patients and methods 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. Results 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 %. Conclusion A novel hitch-and-ride catheter was feasible for biliary cannulation after EUS-RV.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bile Ducts
  • Catheterization / instrumentation
  • Catheterization / methods*
  • Catheters*
  • Cholangiopancreatography, Endoscopic Retrograde / adverse effects
  • Cholangiopancreatography, Endoscopic Retrograde / methods*
  • Endosonography
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Ultrasonography, Interventional