Novel methods to confirm successful puncture in endoscopic ultrasound-guided hepaticogastrostomy

Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is a widely used procedure; however, it is challenging in patients with a nondilated bile duct. Although, the double-wall puncture (Seldinger’s method) can be helpful in such cases ( Fig.1), specific methods to confirm successful puncture have not been established . Aspiration of a large amount of bile can lead to bile duct collapse, making guidewire insertion difficult. On the other hand, if contrast agent is injected without recognizing that the puncture has failed, extravasation may occur outside of the bile duct. This article demonstrate the use of two novel methods to confirm successful EUS-HGS puncture.
Read more: https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-2521-4987
#endoscopy #stomach #liver #treatment #technology #puncture #ultrasound

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