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Transluminal stone removal using innovative basket catheter with snake-shaped sheath via EUS-guided hepaticojejunostomy route (with video)


 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan

Date of Submission30-Jul-2021
Date of Acceptance30-Nov-2021
Date of Web Publication02-May-2022

Correspondence Address:
Takeshi Ogura,
2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakuchou, Takatsukishi, Osaka 569-8686
Japan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/EUS-D-21-00170



How to cite this URL:
Ogura T, Kawai J, Nishiguchi K, Yamamoto Y, Higuchi K. Transluminal stone removal using innovative basket catheter with snake-shaped sheath via EUS-guided hepaticojejunostomy route (with video). Endosc Ultrasound [Epub ahead of print] [cited 2022 Sep 24]. Available from: http://www.eusjournal.com/preprintarticle.asp?id=344252

Transluminal bile duct stone removal via EUS-guided anastomosis has been reported as an alternative treatment technique for patients with failed stone removal under endoscopic retrograde cholangiopancreatography guidance[1] and has a lower likelihood of acute pancreatitis compared with antegrade transpapillary stone removal.[2],[3],[4],[5] Although this procedure has clinical benefits, device insertion into the common bile duct is sometimes difficult because of anatomical variations in the curvature of the intrahepatic or common bile duct and can be complicated by stone migration into a bile duct branch if a balloon catheter is used during the procedure. A novel spiral basket catheter with a snake-shaped sheath (RASEN, KANEKA Medical, Osaka, Japan) designed to overcome these issues has recently become available in Japan [Figure 1]a. The specialized shapes of the basket catheter and sheath enable smooth insertion of the device and reliable stone extraction [Video 1 [Additional file 1]]. We herein describe a case of successful transluminal stone removal using this novel basket catheter.
Figure 1: (a) The novel spiral basket catheter with a snake-shaped sheath (RASEN, KANEKA Medical, Osaka, Japan). (b) Contrast medium is injected into the biliary tract via the EUS-guided hepaticojejunostomy route

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An 82-year-old female who had undergone total gastrectomy was admitted to our hospital with acute cholangitis due to a stone in the common bile duct. EUS-guided hepaticojejunostomy (EUS-HJS) was performed initially, and stone removal was attempted 1 week later using the following technique. A guidewire was inserted into the common bile duct via the EUS-HJS route and contrast medium was injected [Figure 1]b. The basket catheter was then inserted. The snake-shaped sheath enabled the device to be advanced smoothly into the lower common bile duct [Figure 2]a. After stone extraction [Figure 2]b, we successfully removed the device transluminally without any adverse events [Figure 2]c. This novel basket catheter opens a new indication for difficult bile duct stone removal, by the transluminal route as well as the transpapillary route.
Figure 2: (a) The basket catheter is advanced into the lower common bile duct. (b) The stone in the bile duct is successfully grasped using the basket catheter. (c) Removal of the stone into the intestine is performed successfully

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

Takeshi Ogura is an Editorial Board Member of the journal. The article was subject to the journal's standard procedures, with peer review handled independently of this editor and his research groups.



 
  References Top

1.
Kamiyama R, Ogura T, Okuda A, et al. Electrohydraulic lithotripsy for Difficult Bile Duct Stones under endoscopic retrograde cholangiopancreatography and peroral transluminal cholangioscopy guidance. Gut Liver 2018;12:457-62.  Back to cited text no. 1
    
2.
Mukai S, Tsuchiya T, Itoi T. Interventional endoscopic ultrasonography for benign biliary diseases in patients with surgically altered anatomy. Curr Opin Gastroenterol 2019;35:408-15.  Back to cited text no. 2
    
3.
Mukai S, Itoi T. EUS-guided antegrade procedures. Endosc Ultrasound 2019;8:S7-13.  Back to cited text no. 3
    
4.
Iwashita T, Nakai Y, Hara K, et al. Endoscopic ultrasound-guided antegrade treatment of bile duct stone in patients with surgically altered anatomy: A multicenter retrospective cohort study. J Hepatobiliary Pancreat Sci 2016;23:227-33.  Back to cited text no. 4
    
5.
James TW, Fan YC, Baron TH. EUS-guided hepaticoenterostomy as a portal to allow definitive antegrade treatment of benign biliary diseases in patients with surgically altered anatomy. Gastrointest Endosc 2018;88:547-54.  Back to cited text no. 5
    


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