Background Technical tips for device insertion during endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) have not been reported. To improve the technical success rate of device insertion without unnecessary tract dilation, the pushing force should be transmitted directly from the channel of the echoendoscope to the intrahepatic bile duct. Objectives We developed a novel technique, termed the 'moving scope technique', the feasibility of which during EUS-HGS is described. Design Retrospective study. Methods The primary outcome of this study was the technical success rate of dilation device insertion without electrocautery dilation after the moving scope technique. The initial technical success rate of dilation device insertion was defined as successful insertion into the biliary tract. If dilation device insertion failed, the moving scope technique was attempted. Results A total of 143 patients were enrolled in this study. The initial technical success rate for device insertion was 80.4% (115/143). The moving scope technique was therefore attempted in 28 patients. The mean angle between the intrahepatic bile duct and the guidewire was improved to 141.0° and resulted in a technical success rate of 100% (28/28). The area under the ROC curve (AUC) was 0.88, and 120° predicted successful dilation device insertion with sensitivity of 88.0% and specificity of 78.8%. Bile peritonitis (n = 8) and cholangitis (n = 2) were observed as adverse events, but were not severe. Conclusion In conclusion, the moving scope technique may be helpful during EUS-HGS to achieve successful insertion of the dilation device into the biliary tract. These results should be evaluated in a prospective randomized controlled trial.

中文翻译：

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移动镜技术提高了 EUS 引导肝胃造口术期间器械插入的技术成功率（带视频）。

背景 超声内镜引导肝胃造口术 (EUS-HGS) 期间装置插入的技术技巧尚未报道。为了提高装置插入的技术成功率而不进行不必要的管道扩张，推力应从回声内窥镜的通道直接传递到肝内胆管。目标 我们开发了一种新技术，称为“移动示波器技术”，描述了该技术在 EUS-HGS 期间的可行性。设计回顾性研究。方法 本研究的主要结果是移动镜技术后无需电灼扩张的情况下扩张装置插入的技术成功率。扩张装置插入的初始技术成功率定义为成功插入胆道。如果扩张装置插入失败，则尝试移动示波器技术。结果共有143名患者纳入本研究。设备插入的初始技术成功率为 80.4% (115/143)。因此，对 28 名患者尝试了移动内窥镜技术。肝内胆管与导丝之间的平均角度改善至141.0°，技术成功率为100%（28/28）。ROC曲线下面积（AUC）为0.88，120°预测扩张装置成功插入，敏感性为88.0%，特异性为78.8%。观察到胆汁性腹膜炎（n = 8）和胆管炎（n = 2）作为不良事件，但并不严重。结论 总之，移动镜技术可能有助于 EUS-HGS 期间成功地将扩张装置插入胆道。这些结果应在前瞻性随机对照试验中进行评估。