Use of a screw dilator for pancreaticobiliary disease.

BACKGROUND AND AIMS: Creating adequate tracts for device passage remains a challenge in ERCP and therapeutic EUS. We evaluated the technical success and safety of the Tornus ES (Asahi Intecc, Aichi, Japan) screw dilator for tract dilation during therapeutic EUS and ERCP.

METHODS

This retrospective, single-center study analyzed dilation of tracts during therapeutic EUS and ERCP using the Tornus ES from June 2025 to January 2026. Technical success was defined as successful stent placement across the dilated tract.

RESULTS

Twenty-one procedures (20 patients) were performed for biliary strictures, pancreatic duct obstructions, and bile leaks. Technical success was 95% (20 of 21 procedures). Interventions included ERCP (38%) and therapeutic EUS (62%). Adverse events occurred in 40% (8 of 20) of patients-none directly attributed to device failure.

CONCLUSIONS

This first U.S. experience demonstrates that the Tornus ES screw dilator is an effective salvage tool during therapeutic EUS and ERCP for pancreaticobiliary disease.