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Safety and efficacy of endoscopic ultrasound-guided pancreatic duct drainage using a drill dilator: a retrospective study in Japan

  • Ahmed Sadek (Department of Internal Medicine, Faculty of Medicine, Helwan University) ;
  • Kazuo Hara (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Nozomi Okuno (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Shin Haba (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Takamichi Kuwahara (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Toshitaka Fukui (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Minako Urata (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Takashi Kondo (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Yoshitaro Yamamoto (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Kenneth Tachi (Department of Gastroenterology, Aichi Cancer Center Hospital)
  • Received : 2023.10.20
  • Accepted : 2023.11.25
  • Published : 2024.09.30

Abstract

Background/Aims: Dilation of the tract before stent deployment is a challenging step in endoscopic ultrasound-guided pancreatic duct drainage (EUS-PDD). In this study, we examined the effectiveness and safety of a novel spiral dilator, Tornus ES (Asahi Intec), for EUS-PDD. Methods: This was a retrospective, single-arm, observational study at Aichi Cancer Center Hospital. The punctured tract was dilated using a Tornus ES dilator in all EUS-PDD cases. Our primary endpoint was the technical success rate of initial tract dilation. Technical success was defined as successful fistula dilation using a Tornus ES followed by successful stent insertion. Secondary endpoints were procedure times and early adverse events. Results: A total of 12 patients were included between December 2021 and March 2023. EUS-PDD was performed in 11 patients for post-pancreaticoduodenectomy anastomotic strictures and one patient with pancreatitis with duodenal perforation. The technical success rates of stent insertion and fistula dilation using a Tornus ES dilator was 100%. The median procedure time was 24 minutes. No remarkable adverse events related to the procedure were observed, apart from fever, which occurred in 2 patients. Conclusions: Tract dilation in EUS-PDD using a Tornus ES is effective and safe.

Keywords

References

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