title: Feasibility and safety of using Soehendra stent retriever as a new technique for biliary access in endoscopic ultrasound-guided biliary drainage.
abstract: OBJECTIVE
  To assess the feasibility and safety of the use of soehendra stent retriever as a new technique for biliary access in endoscopic ultrasound-guided biliary drainage.
  
  
  METHODS
  The medical records and endoscopic reports of the patients who underwent endoscopic ultrasound-guided biliary drainage (EUS-BD) owing to failed endoscopic retrograde cholangiopancreatography in our institute between June 2011 and January 2014 were collected and reviewed. All the procedures were performed in the endoscopic suite under intravenous sedation with propofol and full anaesthetic monitoring. Then we used the Soehendra stent retriever as new equipment for neo-tract creation and dilation when performing EUS-BD procedures. The patients were observed in the recovery room for 1-2 h and transferred to the regular ward, patients' clinical data were reviewed and analysed, clinical outcomes were defined by using several different criteria. Data were analysed by using SPSS 13 and presented as percentages, means, and medians.
  
  
  RESULTS
  A total of 12 patients were enrolled. The most common indications for EUS-BD in this series were failed common bile duct cannulation, duodenal obstruction, failed selective intrahepatic duct cannulation, and surgical altered anatomy for 50%, 25%, 16.7%, and 8.3%, respectively. Seven patients underwent EUS-guided hepaticogastrostomy (58.3%), and 5 underwent EUS-guided choledochoduodenostomy (41.7%). The technical success rate was 100%, while the clinical success rate was 91.7%. Major and minor complications occurred in 16.6% and 33.3% of patients, respectively, but there were no procedure-related death.
  
  
  CONCLUSIONS
  Soehendra stent retriever could be used as an alternative instrument for biliary access in endoscopic ultrasound guided biliary drainage.
authors.affiliation: Varayu Prachayakul, Siriraj GI Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
authors.forename: Varayu
authors.initials: V
authors.lastname: Prachayakul
authors.affiliation: Varayu Prachayakul, Siriraj GI Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
authors.forename: Pitulak
authors.initials: P
authors.lastname: Aswakul
mesh_terms: D000368:Aged; D057785:Catheters; D002768:Choledochostomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D020878:Device Removal / Q000295:instrumentation*; D004106:Dilatation; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D019160:Endosonography / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: Endoscopic ultrasound-guided biliary drainage; Endoscopic ultrasound-guided choledochoduodenostomy; Endoscopic ultrasound-guided hepaticogastrostomy; Neotract creation; Soehendra stent retriever