Effect of echoendoscope angle on success of guidewire manipulation during endoscopic ultrasound-guided hepaticogastrostomy.
Endoscopy
; 53(4): 369-375, 2021 04.
Article
en En
| MEDLINE
| ID: mdl-32542635
ABSTRACT
BACKGROUND:
With endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), guidewire manipulation might be a critically limiting step for nonexperts. However, the causes of difficult guidewire manipulation remain unclear. The aim of this study was to evaluate factors associated with successful guidewire manipulation.METHODS:
This retrospective cohort study included consecutive patients who underwent EUS-HGS between October 2018 and October 2019.âWe measured scope angle between the long and needle axes of the echoendoscope using still fluoroscopic imaging immediately after puncturing the intrahepatic bile duct. Factors associated with successful guidewire insertion were assessed by multivariable analysis using logistic regression.RESULT:
The influence of the angle between the fine-needle aspiration (FNA) needle and echoendoscope on failed guidewire insertion was assessed using receiver operating characteristic (ROC) curves. Area under the ROC curve was 0.86 (95â% confidence interval [CI] 0.00â-â0.76), and an angle of 135° offered 88.0â% sensitivity and 82.9â% specificity for predicting successful guidewire insertion. According to multivariable analysis, only angle between the FNA needle and echoendoscope >â135° was independently associated with successful guidewire insertion (odd ratio 0.03, 95â%CI 0.01â-â0.14; Pâ<â0.05), whereas sex, puncture site, and diameter of puncture site were not significant factors. After multivariable analysis, all variables were adjusted using age ≥â70 or <â70 years, yielding the same results.CONCLUSION:
The angle between the FNA needle and echoendoscope might be associated with successful guidewire manipulation during EUS-HGS.âAdjusting this angle to 135° before puncturing the intrahepatic bile duct might be helpful in achieving successful guidewire manipulation during EUS-HGS.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Procedimientos Quirúrgicos del Sistema Biliar
/
Endosonografía
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Humans
Idioma:
En
Revista:
Endoscopy
Año:
2021
Tipo del documento:
Article
País de afiliación:
Japón