EUS-guided transmural drainage for peripancreatic fluid collections using fine needle and stiff fine guidewire without electrocautery: An optional safe technique.
Endoscopic transmural drainage by using endoscopic ultrasound (EUS) guidance is not always safe because of the risk of bleeding and perforation. Additionally, the effective area of the EUS-guided procedure using a large diameter needle is relatively narrow. We evaluated the effectiveness and safety of EUS-guided drainage using fine needle and stiff fine guidewire without electrocautery. From November 2006 to July 2008, EUS-guided transmural drainage was performed in six consecutive patients for peripancreatic fluid collections. Puncture via EUS was performed by using a 22-gauge needle. A 0.018-inch guidewire was advanced through the needle and into the peripancreatic fluid collections. After the puncture site was dilated, a 6 Fr tube was immersed in the peripancreatic fluid collections. Five of six patients were successfully drained and treated effectively. One patient was unable to be drained because the dilator could not penetrate the gastric wall. The 22-gauge fine needle and stiff fine guidewire technique can be an alternative to the standard method for difficult puncture sites and risky cases.
Miyatani
Hiroyuki
H
Department of Gastroenterology, Jichi Medical University, Saitama Medical Center, Saitama, Japan.
Yoshida
Yukio
Y
Gastrointest Endosc. 2007 Dec;66(6):1107-19
17892874
Endoscopy. 1997 Feb;29(2):106-8
9101147
Endoscopy. 2006 Apr;38(4):355-9
16680634
Endoscopy. 2001 Dec;33(12):1022-6
11740644
Endoscopy. 1998 Aug;30(6):S71-2
9746177
Gastrointest Endosc. 1998 Aug;48(2):200-3
9717789
Gastrointest Endosc. 2000 Oct;52(4):545-9
11023579
Endoscopy. 1998 Oct;30(8):730-3
9865567
Gastrointest Endosc. 1992 Mar-Apr;38(2):170-1
1568613
Gastrointest Endosc. 2006 Apr;63(4):688-92
16564874
Gastrointest Endosc. 2006 Feb;63(2):223-7
16427925
JOP. 2006 Nov 10;7(6):616-24
17095841
MedGenMed. 2002 Jul 18;4(3):2
12466745
Endoscopy. 2001 Jun;33(6):473-7
11437038
Gastrointest Endosc. 2006 May;63(6):797-803
16650541
Gastrointest Endosc. 1996 Nov;44(5):614-7
8934175