Use of a novel screw-type dilator for endoscopic ultrasonography-guided hepaticogastrostomy via 22-Gauge needle and 0.018-inch guidewire.

Tract dilation is an essential step in completing endoscopic ultrasonography-guided hepaticogastrostomy (EUS-HGS). EUS-HGS using a 22-gauge needle is currently attracting attention; however, the complexity of subsequent dilation and guidewire exchange is problematic. A-60-year-old man with duodenal cancer was referred to our center for the drainage of obstructive jaundice. As endoscopic retrograde cholangiopancreatography was not feasible because of duodenal obstruction, EUS-HGS was performed.