Novel fine gauge electrocautery dilator for endoscopic ultrasound-guided biliary drainage: experimental and clinical evaluation study (with video)

The most important among the steps of endoscopic ultrasound-guided biliary drainage (EUS-BD) is the success of tract dilation. Electrocautery dilation can certainly dilate the biliary or luminal wall. However, bleeding may occur around the dilation site due to burning effects. Here, we describe some technical tips for tract dilation in EUS-BD using a novel electrocautery device. We attempted EUS-BD using the novel electrocautery dilator in 12 patients, among whom nine and three underwent EUS-guided hepaticogastrostomy and EUS-guided gallbladder drainage, respectively. Severe adverse events were not seen in any patients although abdominal pain, which might occur due to stent expansion, was seen in one patient. The novel electrocautery dilator could be inserted into the biliary tract and gallbladder after guidewire placement, and the stent delivery system could also be inserted without additional dilation. Therefore, technical success was achieved in all patients. The procedural durations were less than 20 minutes for each technique. In conclusion, the novel electrocautery dilator might be useful as a tract dilation device, although additional cases and prospective evaluation studies are essential to confirm our results.

• References

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