The utility of an uneven double lumen catheter in endoscopic ultrasound-guided hepaticogastrostomy

Abstract

It is necessary to simplify the procedure of endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) and improve its safety.

An 84-year-old female with jaundice was referred to our hospital. Contrast-enhanced computed tomography and endoscopic biopsy revealed pancreatic head cancer and resulting obstructive jaundice. We performed endoscopic retrograde cholangiopancreatography, but biliary drainage was difficult due to duodenal invasion of pancreatic cancer. Therefore, EUS-HGS using the double guidewire technique was performed. In the usual procedure, the fistula is expanded using a dilator or balloon and then a second guidewire is inserted and placed. However, we simplified the double guidewire technique of EUS-HGS by dilating the fistula and placing the second guidewire using an uneven double lumen catheter. After performing EUS-HGS, the patient recovered from obstructive jaundice and was discharged on the 18th hospital day.