Description of Event or Problem · 0
PUBLICATION: GASTROINTESTINAL ENDOSCOPY, 2026 MAR 3:S0016-5107(26)00156-2. TITLE: USE OF A SCREW DILATOR FOR PANCREATICOBILIARY DISEASE. [EXCERPT] METHODS THIS RETROSPECTIVE STUDY EVALUATED A CONSECUTIVE SERIES OF ALL PATIENTS WHO UNDERWENT THERAPEUTIC EUS OR ERCP WITH USE OF THE TORNUS ES SCREW DILATOR BETWEEN JUNE 2025 AND JANUARY 2026 AT A SINGLE TERTIARY CARE CENTER. PROCEDURES WERE PERFORMED BY A SINGLE EXPERIENCED ENDOSCOPIST (T.H.B., PROFESSOR WITH >25 YEARS OF THERAPEUTIC EUS/ERCP EXPERIENCE). NO EXCLUSION CRITERIA WERE APPLIED. DATA WERE COLLECTED FROM ELECTRONIC MEDICAL RECORDS AND OPERATIVE REPORTS. TECHNICAL SUCCESS WAS DEFINED AS SUCCESSFUL STENT PLACEMENT ACROSS THE DILATED TRACT/DUCT. AES WERE GRADED PER THE ASGE AGREE CLASSIFICATION. [PROCEDURAL TECHNIQUE] AFTER GUIDEWIRE ACCESS (0.025" VISIGLIDE, OLYMPUS), ATTEMPTS WERE MADE TO PASS A 4-MM BALLOON DILATING CATHETER (HURRICANE RX, BOSTON SCIENTIFIC). WHEN THIS FAILED, THE SCREW DILATOR WAS ADVANCED OVER THE WIRE UNTIL RESISTANCE WAS ACHIEVED, THEN ROTATED CLOCKWISE TO THE DESIRED LOCATION AS PREVIOUSLY DESCRIBED. THE DEVICE WAS WITHDRAWN BY COUNTERCLOCKWISE ROTATION. RESULTS TWENTY PATIENTS UNDERWENT 21 PROCEDURES. MEAN AGE WAS 62 ± 13 YEARS, 45% WERE FEMALE, AND MEAN ASA WAS 3.1 ± 0.4. SIX PATIENTS (30%) HAD SURGICALLY ALTERED ANATOMY. EIGHT PROCEDURES (38%) WERE ERCP AND 13 (62%) WERE THERAPEUTIC EUS. TECHNICAL SUCCESS WAS 95% (20/21). AES OCCURRED IN 8/20 PATIENTS (40%). THREE WERE GRADE II (PANCREATITIS), FOUR WERE GRADE IIIA (DUODENAL LEAK, STENT MIGRATION, BLEEDING, AND STENT-RELATED GASTRIC OUTLET OBSTRUCTION), AND ONE WAS GRADE V. DISCUSSION ALL EIGHT AES WERE TYPICAL COMPLICATIONS OF THERAPEUTIC EUS AND ERCP RELATED TO PROCEDURAL COMPLEXITY AND PATIENT DISEASE SEVERITY RATHER THAN DEVICE FAILURE.