A 0.035-inch labeled guidewire with a smaller measured diameter enables a minimal-dilation plastic stent-based endoscopic ultrasound–guided gallbladder drainage workflow: A two-case report

Key Takeaways for GI Nurses

• A newer, labeled 0.035-inch guidewire with a smaller actual measured diameter may allow endoscopic ultrasound (EUS)-guided gallbladder drainage to be performed using a plastic stent without the need for extensive tract dilation, potentially streamlining the procedural workflow nurses assist with.
• Understanding the distinction between a guidewire's labeled size and its true measured diameter is clinically important for accurate device selection, troubleshooting, and anticipating procedural steps during setup and intraprocedural support.
• A minimal-dilation approach may reduce the number of exchanges and accessory devices needed, which has implications for procedural time, instrument tray preparation, and staff familiarity with a streamlined equipment set.
• This case-based innovation reinforces the value of ongoing competency development and hands-on training for endoscopy staff as new devices and modified techniques are introduced into EUS-guided interventions.

Clinical Relevance

EUS-guided gallbladder drainage is an increasingly used alternative for patients who are poor surgical candidates for cholecystectomy or percutaneous drainage, and the technical nuances of the procedure directly affect nursing workflow, room turnover, and patient safety monitoring. This two-case report highlights how a labeled 0.035-inch guidewire with a smaller actual measured diameter can support a minimal-dilation, plastic stent-based approach. For endoscopy nurses, this distinction between labeled and measured wire diameter is a practical reminder that device specifications on packaging may not always reflect functional performance characteristics relevant to tract dilation needs, stent deployment, and compatibility with other accessories on the procedure tray.

From an operational standpoint, a workflow that minimizes the degree of tract dilation required may translate into fewer accessory exchanges during the procedure, which can shorten procedure time and reduce the complexity of instrument setup and turnover between cases. Nurses circulating or assisting during these procedures benefit from understanding the rationale behind device selection, as this knowledge supports smoother intraprocedural communication with the physician, more efficient anticipation of next steps, and better troubleshooting if equipment behaves differently than expected due to diameter discrepancies.

This report also underscores the broader theme of staff development in gastroenterology units: as device innovations and modified techniques emerge, nursing teams must stay current through structured education and hands-on training to safely and efficiently support new approaches. Incorporating case reports like this into unit-based education, competency checklists, or in-service training can help endoscopy nurses build the procedural literacy needed to anticipate equipment needs, recognize when device specifications may differ from expectations, and contribute meaningfully to multidisciplinary discussions about evolving EUS-guided drainage techniques.

Bottom Line

For busy GI nurses, the key takeaway is that not all "0.035-inch" guidewires are truly equivalent—smaller measured diameters can enable simplified, minimal-dilation EUS-guided gallbladder drainage workflows using plastic stents, and staying informed about these device-level nuances through ongoing education supports safer, more efficient procedural support and better readiness for emerging techniques in the endoscopy suite.