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Original Article Safety and efficacy of endoscopic ultrasound-guided pancreatic duct drainage using a drill dilator: a retrospective study from Japan
Ahmed Sadek1,2, Kazuo Hara2,orcid, Nozomi Okuno2orcid, Shin Haba2orcid, Takamichi Kuwahara2orcid, Toshitaka Fukui2orcid, Minako Urata2orcid, Takashi Kondo2orcid, Yoshitaro Yamamoto2orcid, Kenneth Tachi2,3orcid

DOI: https://doi.org/10.5946/ce.2023.272
Published online: January 5, 2024

1Department of Internal Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt

2Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan

3Department of Medicine and Therapeutics, University of Ghana Medical School, Korle Bu Teaching Hospital, Accra, Ghana

Received: 20 October 2023   • Revised: 24 November 2023   • Accepted: 25 November 2023
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Background
/Aims: Dilation of the tract before stent deployment is a challenging step in endoscopic ultrasound-guided pancreatic duct drainage (EUS-PDD). In this study, we examined the effectiveness and safety of a novel spiral dilator, Tornus ES (Asahi Intec), for EUS-PDD.
Methods
This was a retrospective, single-arm, observational study at Aichi Cancer Center Hospital. The punctured tract was dilated using a Tornus ES dilator in all EUS-PDD cases. Our primary endpoint was the technical success rate of initial tract dilation. Technical success was defined as successful fistula dilation using Tornus ES followed by successful stent insertion. Secondary endpoints were procedure times and early adverse events.
Results
A total of 12 patients were included between December 2021 and March 2023. EUS-PDD was performed in 11 patients for post-pancreaticoduodenectomy anastomotic strictures and one patient with pancreatitis with duodenal perforation. The technical success rates of stent insertion and fistula dilation using Tornus ES dilator was 100%. The median procedure time was 24 minutes. No remarkable adverse events related to the procedure were observed, apart from fever, which occurred in 2 patients.
Conclusions
Tract dilation in EUS-PDD using Tornus ES is effective and safe.

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