The "U-wire" technique during ERCP for easy guide wire passage through occluded uncovered metal stents.
نویسندگان
چکیده
A significant number of self-expanding metal stents (SEMSs) placed as conservative therapy for malignant biliary obstruction will become occluded [1]. Stent occlusion can be treated endoscopically either by balloon trawling to remove the biliary sludge and debris or by inserting a polyethylene stent or a second stent through the occluded stent [2]. However, these treatments can be given only after a guide wire is passed through the occluded lumen of the stent into the bile duct beyond [1], and not infrequently during endoscopic retrograde cholangiopancreatography (ERCP), a guidewire accidentally passes through the mesh of an uncovered metal stent, which may result in prolongation of the ERCP procedure or fluoroscopy. Here, we present a simple method that avoids guide wires being unintentionally passed through the stent mesh: the “Uwire” technique. About 2–3cm of the guide wire is first passed out of the sphincterotome, and biliary cannulation is then completed with the sphincterotome (●" Fig.1a). The tip of the wire remains outside the papilla and the body of the wire is advanced into the lumen of the stent along with the sphincterotome. The wire is therefore formed into a “U” shape in the occluded stent and as a result, it can be easily passed through the lumen of the stent without the tip of the wire passing through the mesh (●" Fig.1b–d). This U-wire cannulation method is an extremely effective and simple technique that avoids the risk of accidental passage of a guide wire through the mesh of a metal stent.
منابع مشابه
Evaluation of guide wire cannulation in reduced risk of post - ERCP pancreatitis and facilitated bile duct cannulation
Background: Pancreatitis is most common complication of post-ERCP and needs to admission at least for one day. The purpose of this study was to assess the efficacy of guide wire for better common bile duct (CBD) cannulation for reducing post-ERCP pancreatitis. Methods: From April 2010 through March 2011, the patients who needed ERCP and referred to Shahid Beheshti and Rouhani Teaching Hospita...
متن کاملSide-by-side dual echoendoscope and ultrathin endoscopy to facilitate EUS-ERCP biliary rendezvous.
Endoscopic ultrasound (EUS)-guided biliary access is performed when standard endoscopic retrograde cholangiopancreatography (ERCP) techniques fail and for inaccessible papillae [1]. EUS rendezvous requires passage of the guide wire into the duodenum, with subsequent removal of the echoendoscope and insertion of a second endoscope to grasp the distal end of the wire. During echoendoscope withdra...
متن کاملTwo techniques for guide wire advancement along a tortuous pancreatic duct: the through-the-stent and flipped "U-wire" techniques.
a tortuous pancreatic duct: the through-the-stent and flipped “U-wire” techniques A 52-year-old man with a history of renal transplantation, immunosuppression, and valvular heart disease developed severe acute pancreatitis with a pancreatic pseudocyst. Endoscopic retrograde cholangiopancreatography (ERCP) performed 6 weeks previously had revealed a large pancreatic duct leak requiring the place...
متن کاملNovel wire-guided fine-gauge bougie dilator for transpapillary or endoscopic ultrasonography-guided biliary drainage.
Endoscopic management of biliary stricture generally requires dilation using devices such as an endoscopic retrograde cholangiopancreatography (ERCP) balloon dilation catheter before stenting [1]. Endoscopic ultrasonography (EUS)guided biliary drainage (EUS-BD) also requires fistula dilation before stenting. Recently, ultraslim balloon catheters [1] and diathermic dilators [2] have also been de...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Endoscopy
دوره 44 Suppl 2 UCTN شماره
صفحات -
تاریخ انتشار 2012