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Double Guidewire Technique Using an Uneven Double Lumen Catheter for Endoscopic Ultrasound-Guided Interventions

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Abstract

Background

Endoscopic ultrasonography (EUS)-guided interventions are often performed using a single guidewire (SGW), but there are a few reports on the use of double guidewire (DGW) technique to facilitate multiple drainage placement during EUS-guided drainage of pancreatic fluid collections. This DGW technique may have advantages other than multiple drainage placement during EUS-guided interventions such as scope stabilization, support for stone extraction and device insertion.

Methods

Consecutive patients who underwent EUS-guided interventions between Feb 2012 and Apr 2019 were retrospectively reviewed. The rate and reasons of DGW technique, and clinical outcomes were evaluated. DGW technique was performed, using an uneven double lumen cannula (UDLC), which facilitates insertion of 0.025-in. and 0.035-in. guidewires.

Results

A total of 249 EUS-guided interventions were analyzed, and DGW technique was utilized primarily in 65 cases (25.7%) and as a salvage after failed SGW technique in 18 cases (7.1%). The reasons for DGW technique were 60 multiple drainage placement, 10 scope stabilization, 7 device insertion, 5 safety guidewire, and 4 antegrade stone removal. Insertion of UDLC and DGW was successful in 100%. Technical success rate of preplanned interventions was 92.7% (96.9% in primary DGW and 77.8% in salvage DGW technique). Adverse events were observed in 19.5% after DGW but were not related to DGW technique.

Conclusions

DGW technique using UDLC during EUS-guided interventions was technically feasible and safe. In addition to multiple drainage insertion, it can potentially support complex EUS-guided interventions.

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Authors and Affiliations

  1. Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Yousuke Nakai, Hiroki Oyama, Sachiko Kanai, Kensaku Noguchi, Tatsuya Sato, Ryunosuke Hakuta, Kazunaga Ishigaki, Kei Saito, Tomotaka Saito, Tsuyoshi Hamada, Naminatsu Takahara, Suguru Mizuno, Hirofumi Kogure & Kazuhiko Koike

  2. Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan

    Yousuke Nakai

  3. Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan

    Hiroyuki Isayama

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  1. Yousuke Nakai
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  2. Hiroki Oyama
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  15. Kazuhiko Koike
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Correspondence to Yousuke Nakai.

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Nakai, Y., Oyama, H., Kanai, S. et al. Double Guidewire Technique Using an Uneven Double Lumen Catheter for Endoscopic Ultrasound-Guided Interventions. Dig Dis Sci 66, 1540–1547 (2021). https://doi.org/10.1007/s10620-020-06345-9

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  • DOI: https://doi.org/10.1007/s10620-020-06345-9

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