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CC BY-NC-ND 4.0 · Endosc Int Open 2025; 13: a24873545
DOI: 10.1055/a-2487-3545
Original article

Technical outcomes between a drill dilator and ultra-tapered mechanical dilator during EUS-guided pancreaticogastrostomy: Comparative study

Takeshi Ogura
1   Endoscopy Center, Osaka Medical and Pharmaceutical University, Takatsuki, Japan (Ringgold ID: RIN13010)
,
Saori Ueno
2   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan (Ringgold ID: RIN13010)
,
Atsushi Okuda 
2   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan (Ringgold ID: RIN13010)
,
Nobu Nishioka
2   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan (Ringgold ID: RIN13010)
,
Jun Sakamoto
2   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan (Ringgold ID: RIN13010)
,
Jun Matsuno
2   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan (Ringgold ID: RIN13010)
,
Yuki Uba
2   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan (Ringgold ID: RIN13010)
,
Mitsuki Tomita
2   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan (Ringgold ID: RIN13010)
,
Nobuhiro Hattori
2   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan (Ringgold ID: RIN13010)
,
Junichi Nakamura
2   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan (Ringgold ID: RIN13010)
,
Kimi Bessho
2   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan (Ringgold ID: RIN13010)
,
Hiroki Nishikawa
2   2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan (Ringgold ID: RIN13010)
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Abstract

Background and study aims

Endoscopic ultrasound-guided pancreaticogastrostomy (EUS-PGS) is performed for patients who have failed ERCP. Tract dilation is one of the challenging procedural steps during EUS-PGS. Recently, a bougie dilator, the drill dilator, has become available. With this device, tract dilation can be easily performed without pushback of the echoendoscope, allowing stable scope positioning to be achieved during tract dilation. However, comparative studies between ultra-tapered mechanical and drill dilators have not been reported. The aim of this study was to compare the technical outcomes of these dilation devices.

Patients and methods

Symptomatic patients with main pancreatic duct (MPD) strictures from January 2021 to November 2023 were included in this retrospective study. The technical success rate of tract dilation was first evaluated. Overall technical success rate, procedure time, and adverse events were evaluated as secondary outcomes.

Results

The technical success rate of initial device insertion into the MPD was higher with the Tornus ES (100%, 12/12) compared with the ES dilator (60%, 9/15) (P=0.013). Additional tract dilation rate to deploy the stent was needed in 86.7% (13/15) in the ES dilator group, and 8.3% (1/12) in the Tornus group (P=0.001) and the overall technical success rate in the Tornus ES group was 100% (12/12). Mean procedure time was shorter in the Tornus ES group (13.38±3.80 min) compared with the ES dilator group (21.40±1.54 min) (P=0.0013).

Conclusions

In conclusion, Tornus ES might be considered as the initial dilation device during EUS-PGS.

Keywords

Endoscopic ultrasonography - Intervention EUS - Pancreas


Publication History

Received: 08 November 2024

Accepted: 22 November 2024

Accepted Manuscript online:
25 November 2024

Article published online:
07 January 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Takeshi Ogura, Saori Ueno, Atsushi Okuda, Nobu Nishioka, Jun Sakamoto, Jun Matsuno, Yuki Uba, Mitsuki Tomita, Nobuhiro Hattori, Junichi Nakamura, Kimi Bessho, Hiroki Nishikawa. Technical outcomes between a drill dilator and ultra-tapered mechanical dilator during EUS-guided pancreaticogastrostomy: Comparative study. Endosc Int Open 2025; 13: a24873545.
DOI: 10.1055/a-2487-3545
 

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