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DOI: 10.1055/s-2007-1018131
Transpapillary Placement of an Endoprosthesis with the Aid of the Frimberger Varioguide
Publication History
Publication Date:
17 March 2008 (online)
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Summary
The guide wire, an important requisite for the placement of endoscopic transpapillary biliary prostheses, should combine two, normally incompatible, properties: a high degree of flexibility for atraumatic passage through irregular or “bent” stenoses, and a high degree of stiffness, to prevent sidewise deviation during advancement of the prosthesis. These opposing, formerly incompatible, properties are combined in a new type of guide wire, known as the Varioguide.
With the aid of a tension controller, the stiffness of the Varioguide can be varied steplessly.
In 88.2 % of 68 patients with stenosis of the bile duct we succeeded in placing a transpapillary endoprosthesis with the Varioguide. In 13 cases in which a previous attempt with the conventional guide wire was unsuccessful, placement of the endoprosthesis was successfully accomplished with the Varioguide; the reverse was true in only a single patient.
In the case of very narrow, rigid high stenoses, in which placement of a transpapillary endoprosthesis is especially difficult, the Varioguide has proved highly suitable (stenoses of the bile duct bifurcation).
Key words:
Biliary stenosis - Stenosis of the common bile duct - Endoprosthesis - Biliary endoprosthesis - Endoscopic placement of prosthesis - Guide - Varioguide