EUS-Guided Biliary Drainage 22 Aug 2021 12:55 13:20

EUS-Guided Biliary Drainage 22 Aug 2021 12:55 13:20

(25 mins)
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Endosonography (EUS)-guided interventions are developing day by day. EUS-guided biliary drainage is accepted as salvage procedure when standard ERCP is difficult or failed. However, EUS-BD may cause severe complications, such as peritonitis and perforations because of non-adhesion between gastrointestinal tract and target organ. To spread EUS-BD, safe procedure is most important. In this lecture, I will introduce our procedure and explain how to manage and minimize the complication.
We developed EG-580-UT (FujiFilm Medical, Tokyo, Japan) with R&D team of FujiFilm, a convex type EUS-scope for performance of interventional EUS. The scope angulation is very powerful and deep even 19G FNA needle inside and elevator up angle is very acute. Then, we can puncture wide are with EG 580UT. The devices for performing EUS-BD in our institution will be shown in this lecture. Details and tips of EUS-HGS will be introduced; puncture point, GW manipulation, balloon dilation technique, double GW technique, etc. Stent migration into abdominal cavity is one of the most severe complication. Using long covered SEMS, making anchor technique and recent stent with effective anchoring were introduced. Pancreato-biliary endoscopic intervention including EUS-guided procedures, quality of fluoroscopy is very important to make our procedures succeeded. Wire Optimum Weighted imaging (WOW) mode, which was developed by Fujifilm company and us, and realized the fluoroscopic subtraction image of background during the procedure. The images of GW and device overlapped with supine, intestinal gas was much improved with WOW mode. WOW may change our procedure. The author believe that this lecture may contribute to minimize the complications related with EUS-BD procedure in your institution.

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