Dataset Information

Three-year evaluation of a novel, nonfluoroscopic, all-artificial model for EUS-guided biliary drainage training for the impact to practice: A prospective observational study (with videos).

ABSTRACT:

Background and objectives

EUS-guided biliary drainage (EUS-BD) required a dedicated training. We developed and evaluated a nonfluoroscopic, all-artificial training model known as Thai Association for Gastrointestinal Endoscopy Model 2 (TAGE-2) for the training of EUS-guided hepaticogastrostomy (EUS-HGS) and EUS-guided choledochoduodenostomy (EUS-CDS). We hypothesize that trainers and trainees would appreciate the ease of the nonfluoroscopy model and increase their confidence to start their real procedures in humans.

Materials and methods

We prospectively evaluated the TAGE-2 launched in two international EUS hands-on workshops and have followed trainees for 3 years to see long-term outcomes. After completing the training procedure, the participants answered questionnaires to assess their immediate satisfaction of the models in and also the impact of these models on their clinical practice 3 years after the workshop.

Results

A total of 28 participants used the EUS-HGS model and 45 participants used the EUS-CDS model. The EUS-HGS model was rated as excellent by 60% of beginners and 40% by experienced and the EUS-CDS model was rated as excellent by 62.5% of beginners and 57.2% of experienced. The majority of trainees (85.7%) have started the EUS-BD procedure in humans without additional training in other models.

Conclusion

Our nonfluoroscopic, all-artificial model for EUS-BD training is convenient to be used with good-to-excellent satisfaction scored by the participants in most aspects. It can help the majority of trainees start their procedures in humans without additional training in other models.

SUBMITTER: Chantarojanasiri T

PROVIDER: S-EPMC10134934 | biostudies-literature | 2023 Jan-Feb

REPOSITORIES: biostudies-literature

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Publications

Three-year evaluation of a novel, nonfluoroscopic, all-artificial model for EUS-guided biliary drainage training for the impact to practice: A prospective observational study (with videos).

Chantarojanasiri Tanyaporn T Siripun Aroon A Kongkam Pradermchai P Pausawasdi Nonthalee N Ratanachu-Ek Thawee T

Endoscopic ultrasound 20230101 1

<h4>Background and objectives</h4>EUS-guided biliary drainage (EUS-BD) required a dedicated training. We developed and evaluated a nonfluoroscopic, all-artificial training model known as Thai Association for Gastrointestinal Endoscopy Model 2 (TAGE-2) for the training of EUS-guided hepaticogastrostomy (EUS-HGS) and EUS-guided choledochoduodenostomy (EUS-CDS). We hypothesize that trainers and trainees would appreciate the ease of the nonfluoroscopy model and increase their confidence to start the ...[more]

PMID: 36861508

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Project description:Background and aimsEUS-guided biliary drainage (EUS-BD) has been performed increasingly worldwide, especially in patients with malignant tumors in which ERCP is difficult, patients with surgically altered GI tracts, and older patients who are at high risk for surgery. EUS-BD requires high-level skills and has limited options for managing adverse events, particularly when stent migration and cholangitis occur. Adverse events, such as persistent bile leakage from the fistula and continuous reflux from the GI tract, are believed to always have a risk of severe exacerbation that could threaten the patient's life.MethodsWe encountered 2 cases of stent migrations and 1 case with repeated cholangitis in patients with malignant tumors among the patients who underwent EUS-BD. The migrated stent was visualized under EUS in 2 patients with stent migration, and an EUS-guided FNA needle was used to puncture the mesh of the stent. The cannulation catheter was directly inserted into the mesh of the stent in 1 case with repeated retrograde cholangitis, while the stent was visualized with an endoscope. Subsequently, a guidewire was inserted through the puncture site, and a second metal stent was deployed between the meshes of the first stent, bridging the GI wall again (Lambda stenting technique). All procedures were performed with the patient under general anesthesia, and the patients safely completed the intervention.ResultsPatients' conditions significantly improved after the second stent insertion, allowing for chemotherapy resumption while maintaining their activities of daily living. The second stent remained in place without any migration, and the stent successfully prevented further cholangitis.ConclusionsThe Lambda stenting technique is considered highly effective for managing stent migration and repeated cholangitis, which is a major EUS-BD adverse event. This procedure helps avoid more invasive surgeries when stent migration and cholangitis occur and contributes to expanding EUS-BD applicability.

Dataset Information

Three-year evaluation of a novel, nonfluoroscopic, all-artificial model for EUS-guided biliary drainage training for the impact to practice: A prospective observational study (with videos).

Background and objectives

Materials and methods

Results

Conclusion

Publications

Three-year evaluation of a novel, nonfluoroscopic, all-artificial model for EUS-guided biliary drainage training for the impact to practice: A prospective observational study (with videos).

Similar Datasets

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