Hae Won Yoo1, Jong Ho Moon1, Seok Jung Jo1, Yun Nah Lee1, Jae Keun Park1, Tae Hoon Lee2, Sang-Woo Cha3, Young Deok Cho3, Sang-Heum Park2, Se Ik Park4, Seok Jeong5, Don Haeng Lee5. 1. Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Republic of Korea. 2. Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Cheonan, Republic of Korea. 3. Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Seoul, Republic of Korea. 4. Department of Research and Development, Taewoong Medical, Ilsan, Republic of Korea. 5. Digestive Disease Center and Research Institute, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
Abstract
BACKGROUND: The use of a lumen-apposing metal stent (LAMS) capable of one-step endoscopic ultrasound-guided transmural drainage (EUS-TD) can increase the effectiveness of the procedure. We evaluated the newly developed electrocautery-enhanced (EC) delivery system with a LAMS for one-step EUS-guided gallbladder drainage (EUS-GBD) or choledochoduodenostomy (EUS-CDS). METHODS: In the animal experiment, an EC-LAMS was advanced into the gallbladder without prior tract dilation in four pigs. A conventional LAMS was inserted in another four pigs as a control group. After the animal experiment, 17 patients underwent EUS-TD using the EC-LAMS (EUS-GBD in 10 patients, EUS-CDS in 7). The primary outcome was the technical success rate. RESULTS: In the animal study, the mean procedure time was significantly shorter in the EC-LAMS group than in the conventional LAMS group. In the human study, the overall technical success rate was 94.1 %, with one EUS-GBD failure. The clinical success rate was 100 %. The overall adverse event rate was 17.6 %. CONCLUSIONS: One-step EUS-GBD or EUS-CDS using the novel EC-LAMS is a feasible approach that achieves a high success rate and maintains safety. Thieme. All rights reserved.
BACKGROUND: The use of a lumen-apposing metal stent (LAMS) capable of one-step endoscopic ultrasound-guided transmural drainage (EUS-TD) can increase the effectiveness of the procedure. We evaluated the newly developed electrocautery-enhanced (EC) delivery system with a LAMS for one-step EUS-guided gallbladder drainage (EUS-GBD) or choledochoduodenostomy (EUS-CDS). METHODS: In the animal experiment, an EC-LAMS was advanced into the gallbladder without prior tract dilation in four pigs. A conventional LAMS was inserted in another four pigs as a control group. After the animal experiment, 17 patients underwent EUS-TD using the EC-LAMS (EUS-GBD in 10 patients, EUS-CDS in 7). The primary outcome was the technical success rate. RESULTS: In the animal study, the mean procedure time was significantly shorter in the EC-LAMS group than in the conventional LAMS group. In the human study, the overall technical success rate was 94.1 %, with one EUS-GBD failure. The clinical success rate was 100 %. The overall adverse event rate was 17.6 %. CONCLUSIONS: One-step EUS-GBD or EUS-CDS using the novel EC-LAMS is a feasible approach that achieves a high success rate and maintains safety. Thieme. All rights reserved.
Authors: Benedetto Mangiavillano; Jong Ho Moon; Antonio Facciorusso; Francesco Di Matteo; Danilo Paduano; Milutin Bulajic; Andrew Ofosu; Francesco Auriemma; Laura Lamonaca; Hae Won Yoo; Roberta Rea; Marco Massidda; Alessandro Repici Journal: Endosc Int Open Date: 2022-07-15
Authors: Alberto Larghi; Stefano Francesco Crinò; Giuseppe Vanella; Gianenrico Rizzatti; Laura Bernardoni; Paolo Giorgio Arcidiacono Journal: Endosc Ultrasound Date: 2022 Jan-Feb Impact factor: 5.628