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 newly reported 0.035-inch labeled guidewire with a smaller actual measured diameter may allow EUS-guided gallbladder drainage (EUS-GBD) to be performed with a plastic stent using minimal tract dilation, potentially simplifying procedural setup and instrument selection.
• Understanding the distinction between a guidewire's labeled size and its true measured diameter is clinically important, as this discrepancy is the technical basis for the streamlined workflow described in this case report.
• Nurses assisting in EUS-GBD procedures should anticipate potential changes to standard tray setups, including fewer or smaller dilation devices, and should be prepared to verify wire compatibility with stent delivery systems during case planning.
• As a two-case report, this technique is early-stage; nurses should stay alert for follow-up studies validating safety, reproducibility, and outcomes before this becomes standard practice.

Clinical Relevance

EUS-guided gallbladder drainage has become an important option for patients with acute cholecystitis who are poor surgical candidates, but the procedure traditionally requires tract dilation before stent placement—a step that adds procedural time, instrumentation, and potential risk of bleeding or bile leakage. This case report highlights a technical innovation: a 0.035-inch labeled guidewire whose actual measured diameter is smaller than expected, allowing plastic stent delivery systems to pass through the EUS-created tract with minimal or no dilation. For endoscopy nurses, this has direct implications for procedural workflow, equipment preparation, and patient safety monitoring. From an operational standpoint, minimizing dilation steps could shorten procedure times and reduce the number of accessory exchanges during a technically demanding intervention. This may translate into decreased fluoroscopy exposure, reduced sedation duration, and potentially fewer opportunities for procedural complications such as stent misdeployment or tract disruption. Nurses responsible for tray setup and instrument tracking should be aware that guidewire specifications on packaging may not fully reflect functional diameter—an important patient safety consideration when selecting compatible devices for a given stent delivery system. Close communication with physicians about wire selection, and careful documentation of the specific guidewire and stent combination used, will be valuable as institutions begin to evaluate this approach. For professional development, this report reinforces the importance of staying current with device-level nuances in interventional EUS techniques, an area of endoscopy that continues to evolve rapidly. Nurses who understand the rationale behind minimal-dilation workflows will be better equipped to anticipate physician needs intraprocedurally, troubleshoot equipment issues, and educate patients and colleagues about newer, less invasive drainage options. While this is only a two-case report and larger studies are needed to confirm safety and reproducibility, it signals a potential shift toward simplified EUS-GBD workflows that GI nurses should monitor as the evidence base develops.

Bottom Line

This two-case report suggests that a 0.035-inch labeled guidewire with a smaller-than-expected actual diameter may enable EUS-guided gallbladder drainage with minimal tract dilation, potentially simplifying procedural workflow and reducing steps—information GI nurses should note as an emerging technique to watch, while recognizing that broader validation is still needed before changing standard practice.