Strategic International Session2(JGES・JSGE・JSGS)
Fri. November 3rd   9:00 - 12:00   Room 11: Portopia Hotel South Wing Topaz
Troubleshooting in EUS-CDS
Nozomi Okuno1, Shin Haba1, Kazuo Hara1
1Department of Gastroenterology, Aichi Cancer Center Hospital
Background We had reported the usefulness of EUS-CDS using a forward-viewing scope with FCSEMS and efficacy of changing the direction of the stent to anal side. Currently, we perform EUS-CDS with 19G Acquire without dilation. In addition, since 2018 we have managed re-intervention of EUS-CDS with the goal of stent-free by stent removal or some interventions. We will present the clinical results and recent management methods with video.
Patients and Methods A total 256 cases of EUS-CDS from September 2003 to February 2023, and 177 cases using FCSEMS were retrospectively collected.
Results Early adverse events were occurred in 6.8%(12/177: peritonitis/acute cholangitis/double penetration/acute cholecystitis/hemorrhage/fever/stent membrane damage (with duplication) 4/3/2/2/2/1/1). Combination of forward-viewing EUS and changing stent direction could decrease the complication rate to 4.8% (6/126). Double penetration was not seen in forward-viewing EUS. 22 cases were punctured with 19G Acquire, and only one case (4.5%) required dilation. Stent dislocation was occurred in 21.5% (38/177). 17 cases did not require re-intervention, and 9 cases needed balloon dilation, and finally 68.4% (26/38) cases became stent free. Stent removal was performed in 13.0% (23/177), and 69.6% (16/23) cases finally became stent free.
Conclusions Our strategy of EUS-CDS was probably useful and safe. The new re-intervention strategy aiming stent-free using the fistula showed a high achievement rate. It may be useful for benign disease and malignant disease with a long prognosis because of no troubles cause by stents.
Index Term 1: EUS-CDS
Index Term 2: Troubleshooting
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