Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2015; 21(9): 2725-2730
Published online Mar 7, 2015. doi: 10.3748/wjg.v21.i9.2725
Feasibility and safety of using Soehendra stent retriever as a new technique for biliary access in endoscopic ultrasound-guided biliary drainage
Varayu Prachayakul, Pitulak Aswakul
Varayu Prachayakul, Siriraj GI Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Pitulak Aswakul, Liver and Digestive Institute, Samitivej Sukhumvit Hospital, Wattana, Bangkok 10120, Thailand
Author contributions: Prachayakul V initiated the intellectual conception of the manuscript; and Prachayakul V and Aswakul P contributed equally in data collection, drafted, revised the manuscript and approved the final version.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Varayu Prachayakul, MD, Siriraj GI Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. kaiyjr@gmail.com
Telephone: +66-818654646 Fax: +66-24121088
Received: July 24, 2014
Peer-review started: July 25, 2014
First decision: August 15, 2014
Revised: September 4, 2014
Accepted: December 5, 2014
Article in press: December 8, 2014
Published online: March 7, 2015
Abstract

AIM: To assess the feasibility and safety of the use of soehendra stent retriever as a new technique for biliary access in endoscopic ultrasound-guided biliary drainage.

METHODS: The medical records and endoscopic reports of the patients who underwent endoscopic ultrasound-guided biliary drainage (EUS-BD) owing to failed endoscopic retrograde cholangiopancreatography in our institute between June 2011 and January 2014 were collected and reviewed. All the procedures were performed in the endoscopic suite under intravenous sedation with propofol and full anaesthetic monitoring. Then we used the Soehendra stent retriever as new equipment for neo-tract creation and dilation when performing EUS-BD procedures. The patients were observed in the recovery room for 1-2 h and transferred to the regular ward, patients’ clinical data were reviewed and analysed, clinical outcomes were defined by using several different criteria. Data were analysed by using SPSS 13 and presented as percentages, means, and medians.

RESULTS: A total of 12 patients were enrolled. The most common indications for EUS-BD in this series were failed common bile duct cannulation, duodenal obstruction, failed selective intrahepatic duct cannulation, and surgical altered anatomy for 50%, 25%, 16.7%, and 8.3%, respectively. Seven patients underwent EUS-guided hepaticogastrostomy (58.3%), and 5 underwent EUS-guided choledochoduodenostomy (41.7%). The technical success rate was 100%, while the clinical success rate was 91.7%. Major and minor complications occurred in 16.6% and 33.3% of patients, respectively, but there were no procedure-related death.

CONCLUSION: Soehendra stent retriever could be used as an alternative instrument for biliary access in endoscopic ultrasound guided biliary drainage.

Keywords: Soehendra stent retriever, Endoscopic ultrasound-guided choledochoduodenostomy, Neotract creation, Endoscopic ultrasound-guided biliary drainage, Endoscopic ultrasound-guided hepaticogastrostomy

Core tip: Endoscopic ultrasound-guided biliary drainage is considered an alternative treatment for the patients who failed endoscopic retrograde cholangiopancreatography. We proposed that the technical and clinical success rate, including complications were related to the techniques of biliary access which demonstrated an impressive outcomes using the selfmade-tapered tip Teflon catheters for neo-tract creation. In this case series, we would like to shared our experiences using Soehendra stent retrievers as a new technique for biliary access in endoscopic ultrasound-guided biliary drainage.