A novel method for performing multiple wire insertions during endoscopic cyst gastrostomy.
BACKGROUND
Endoscopic cyst gastrostomy is effective in the management of uncomplicated pancreatic pseudocysts. A challenging aspect of the procedure is the insertion and confirmation of at least 2 guidewires into the cyst. Many technical procedures to accomplish the wire insertion have been described but are complicated.


OBJECTIVE
We describe the use of a simple commercially available catheter that allows multiple wires to be inserted into a pancreatic pseudocyst as an efficient and simple means of performing a cyst gastrostomy.


METHODS
Case series.


METHODS
Academic referral center.


METHODS
Four consecutive patients undergoing EUS-guided cyst gastrostomy.


METHODS
A Haber ramp was used as the means for the introduction of multiple wires into a pancreatic pseudocyst.


METHODS
Technical success without loss of wire access during the cyst gastrostomy.


RESULTS
Four patients underwent successful pancreatic cyst gastrostomy. There was no loss of wire access during the procedure. There were no intraprocedure or postprocedure complications.


CONCLUSIONS
Small patient population.


CONCLUSIONS
The use of the Haber ramp provides a simple and efficient means for introducing, ensuring, and maintaining wire access during the creation of an endoscopic cyst gastrostomy.
Evans
John A
JA
Division of Gastroenterology, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina, USA. georg.spaun@gmail.com
Conway
Jason D
JD
Mishra
Girish
G
D002404:Catheterization; D016099:Endoscopy, Gastrointestinal; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D010192:Pancreatic Pseudocyst / Q000601:surgery*