Enterostomy was performed with Giovannini cystostome (Cystotome
Stent placement in all patients was facilitated with electrical needle knife (Cystotome).
Electrical needle knife (Cystotome), catheter dilator, and balloon dilator could be used to facilitate stent placement during EUS-BD procedures.
Caption: FIGURE 1: EUS-BD in a patient with a periampullary tumor with unidentifiable ampulla and failed ERCP: (a) endoscopy view of the periampullary tumor; (b) EUS imaging of the puncture into dilated CBD; (c) puncture point enlargement using Cystotome; (d) dilated intraand extrahepatic CBD; (e) transduodenal plastic biliary stent placement; (f) bile drainage through the stent.
Another patient with bilio-enteric tract dilation using cystotome
and graded dilation technique developed self-limited bleeding (melena) 2 days postoperatively, which was resolved with conservative treatment.
27-gauge cystotome is introduced through 9 o'clock side port.
performed CCC with the anterior chamber maintainer using cystotome .
In white cataract, the anterior capsule could be perforated with cystotome and a milky material fills in anterior chamber.
Cystotome (10-Fr, Wilson-Cook Medic) is used to dilate the tract and create a large fistula.
The needle path is then dilated by the cystotome and a balloon dilator.
So, needle path dilation by cystotome or balloon was needed even they may have the higher risk of cyst rupture.
The following accessories are used for dilation of newly created fistula in selected cases (especially in transluminal and antegrade stenting): 6-10 Fr bougie (SBDC; (Cook Medical Inc, Bloomington, IN, USA)), 4-6 mm dilation balloon (Boston Scientific, Natick, MA, USA), ERCP 3.9-4.9 Fr sphincterotome (Boston Scientific, Natick, MA, USA), 5.5 Fr Needle Knife cautery (Boston Scientific, Natick, MA, USA), or 6-8.5 Fr Cystotome
(EndoFlex, Voerde, Germany).