A Proposed Algorithm for Endoscopic Ultrasound-Guided Rendezvous Technique in Failed Biliary Cannulation
Background: The selection of an approach route in endoscopic ultrasound-guided rendezvous (EUS-RV) for failed biliary cannulation is complicated. We proposed an algorithm for EUS-RV. Methods: We retrospectively evaluated consecutive EUS-RV cases between April 2017 and July 2020. Puncturing the dista...
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| Format: | Article |
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MDPI AG
2020-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/12/3879 |
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| author | Saburo Matsubara Keito Nakagawa Kentaro Suda Takeshi Otsuka Hiroyuki Isayama Yousuke Nakai Masashi Oka Sumiko Nagoshi |
| author_facet | Saburo Matsubara Keito Nakagawa Kentaro Suda Takeshi Otsuka Hiroyuki Isayama Yousuke Nakai Masashi Oka Sumiko Nagoshi |
| author_sort | Saburo Matsubara |
| collection | DOAJ |
| description | Background: The selection of an approach route in endoscopic ultrasound-guided rendezvous (EUS-RV) for failed biliary cannulation is complicated. We proposed an algorithm for EUS-RV. Methods: We retrospectively evaluated consecutive EUS-RV cases between April 2017 and July 2020. Puncturing the distal extrahepatic bile duct (EHBD) from the duodenal second part (D2) (DEHBD/D2 route) was attempted first. If necessary, puncturing the proximal EHBD from the duodenal bulb (D1) (PEHBD/D1 route), puncturing the left intrahepatic bile duct (IHBD) from the stomach (LIHBD/S route), or puncturing the right IHBD from the D1 (RIHBD/D1 route) were attempted in this order. Results: A total of 16 patients were included. The DEHBD/D2 route was used in 10 (62.5%) patients. The PEHBD/D1 route was attempted in five (31.3%) patients, and the biliary puncture failed in one patient in whom the RIHBD/D1 route was used because of tumor invasion to the left hepatic lobe. The LIHBD/S route was applied in one (6.3%) patient. Successful biliary cannulation was achieved in all patients eventually. The time from the puncture to the guidewire placement in the DEHBD/D2 route (3.5 min) was shorter than that in other methods (14.0 min) (<i>p</i> = 0.014). Adverse events occurred in one (6.3%) patient with moderate pancreatitis. Conclusions: The proposed algorithm might be useful for the selection of an appropriate approach route in EUS-RV. |
| first_indexed | 2024-03-10T14:27:58Z |
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| language | English |
| last_indexed | 2024-03-10T14:27:58Z |
| publishDate | 2020-11-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-2ed6850b41284244b9c45234f6df2d832023-11-20T22:49:13ZengMDPI AGJournal of Clinical Medicine2077-03832020-11-01912387910.3390/jcm9123879A Proposed Algorithm for Endoscopic Ultrasound-Guided Rendezvous Technique in Failed Biliary CannulationSaburo Matsubara0Keito Nakagawa1Kentaro Suda2Takeshi Otsuka3Hiroyuki Isayama4Yousuke Nakai5Masashi Oka6Sumiko Nagoshi7Saitama Medical Center, Department of Gastroenterology and Hepatology, Saitama Medical University, Saitama 350-8550, JapanSaitama Medical Center, Department of Gastroenterology and Hepatology, Saitama Medical University, Saitama 350-8550, JapanSaitama Medical Center, Department of Gastroenterology and Hepatology, Saitama Medical University, Saitama 350-8550, JapanSaitama Medical Center, Department of Gastroenterology and Hepatology, Saitama Medical University, Saitama 350-8550, JapanDepartment of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, JapanSaitama Medical Center, Department of Gastroenterology and Hepatology, Saitama Medical University, Saitama 350-8550, JapanSaitama Medical Center, Department of Gastroenterology and Hepatology, Saitama Medical University, Saitama 350-8550, JapanBackground: The selection of an approach route in endoscopic ultrasound-guided rendezvous (EUS-RV) for failed biliary cannulation is complicated. We proposed an algorithm for EUS-RV. Methods: We retrospectively evaluated consecutive EUS-RV cases between April 2017 and July 2020. Puncturing the distal extrahepatic bile duct (EHBD) from the duodenal second part (D2) (DEHBD/D2 route) was attempted first. If necessary, puncturing the proximal EHBD from the duodenal bulb (D1) (PEHBD/D1 route), puncturing the left intrahepatic bile duct (IHBD) from the stomach (LIHBD/S route), or puncturing the right IHBD from the D1 (RIHBD/D1 route) were attempted in this order. Results: A total of 16 patients were included. The DEHBD/D2 route was used in 10 (62.5%) patients. The PEHBD/D1 route was attempted in five (31.3%) patients, and the biliary puncture failed in one patient in whom the RIHBD/D1 route was used because of tumor invasion to the left hepatic lobe. The LIHBD/S route was applied in one (6.3%) patient. Successful biliary cannulation was achieved in all patients eventually. The time from the puncture to the guidewire placement in the DEHBD/D2 route (3.5 min) was shorter than that in other methods (14.0 min) (<i>p</i> = 0.014). Adverse events occurred in one (6.3%) patient with moderate pancreatitis. Conclusions: The proposed algorithm might be useful for the selection of an appropriate approach route in EUS-RV.https://www.mdpi.com/2077-0383/9/12/3879endoscopic ultrasoundendoscopic retrograde cholangiopancreatographyrendezvousbiliary cannulationalgorithm |
| spellingShingle | Saburo Matsubara Keito Nakagawa Kentaro Suda Takeshi Otsuka Hiroyuki Isayama Yousuke Nakai Masashi Oka Sumiko Nagoshi A Proposed Algorithm for Endoscopic Ultrasound-Guided Rendezvous Technique in Failed Biliary Cannulation Journal of Clinical Medicine endoscopic ultrasound endoscopic retrograde cholangiopancreatography rendezvous biliary cannulation algorithm |
| title | A Proposed Algorithm for Endoscopic Ultrasound-Guided Rendezvous Technique in Failed Biliary Cannulation |
| title_full | A Proposed Algorithm for Endoscopic Ultrasound-Guided Rendezvous Technique in Failed Biliary Cannulation |
| title_fullStr | A Proposed Algorithm for Endoscopic Ultrasound-Guided Rendezvous Technique in Failed Biliary Cannulation |
| title_full_unstemmed | A Proposed Algorithm for Endoscopic Ultrasound-Guided Rendezvous Technique in Failed Biliary Cannulation |
| title_short | A Proposed Algorithm for Endoscopic Ultrasound-Guided Rendezvous Technique in Failed Biliary Cannulation |
| title_sort | proposed algorithm for endoscopic ultrasound guided rendezvous technique in failed biliary cannulation |
| topic | endoscopic ultrasound endoscopic retrograde cholangiopancreatography rendezvous biliary cannulation algorithm |
| url | https://www.mdpi.com/2077-0383/9/12/3879 |
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