An international multicenter study comparing EUS-guided pancreatic duct drainage with enteroscopy-assisted endoscopic retrograde pancreatography after Whipple surgery

Chen, Yen I.; Levy, Michael J.; Moreels, Tom G.; Hajijeva, Gulara; Will, Uwe; Artifon, Everson L.A.; Hara, Kazuo; Kitano, Masayuki; Topazian, Mark D.; Dayyeh, Barham Abu; Reichel, Andreas; Vilela, Tiago; Ngamruengphong, Saowanee; Haito-Chavez, Yamile; Bukhari, Majidah; Okolo, Patrick I.; Kumbhari, Vivek; Ismail, Amr; Khashab, Mouen A.

doi:10.1016/j.gie.2016.07.031

Cited by 116 publications

(104 citation statements)

References 26 publications

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“…Thus, the EUS approach provides an important alternative in these patients. In a recent study comparing EUS-PD with enteroscopy-assisted ERP, EUS-PD was associated with significantly higher technical and clinical success rates (92.5% vs 20%, P<0.001%; and 87.5% vs 23.5%, P<0.001, respectively) 121. However, there were also significantly more mild to moderate adverse events in the EUS-PD group (35% vs 2.9%, P<0.001) without significant differences in procedural times and hospital stay.…”

Section: Resultsmentioning

confidence: 96%

Consensus guidelines on the optimal management in interventional EUS procedures: results from the Asian EUS group RAND/UCLA expert panel

Teoh

Dhir²,

Kida

et al. 2018

Gut

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Section: Resultsmentioning

confidence: 96%

Consensus guidelines on the optimal management in interventional EUS procedures: results from the Asian EUS group RAND/UCLA expert panel

Teoh

Dhir²,

Kida

et al. 2018

Gut

Self Cite

180

185

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“…Procedure time and length of stay were not significantly different between the 2 groups. AEs included abdominal pain requiring hospitalization, intraabdominal abscesses and jejunal ulceration secondary to pancreatic stent placement [34]. Although there were no severe AEs with EUS-PDI in this study, the overall complication rate of 30% is very high.…”

Section: Outcomes Of Eus-pdimentioning

confidence: 85%

Endoscopic Ultrasound-Guided Pancreatic Duct Intervention

et al. 2017

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Endoscopic ultrasound-guided pancreatic duct intervention (EUS-PDI) is an emerging endoscopic approach allowing access and intervention to the pancreatic duct (PD) for patients with failed endoscopic retrograde pancreatography (ERP) or patients with surgically altered anatomy. As opposed to biliary drainage for which percutaneous drainage is an alternative following failed endoscopic retrograde cholangiopancreatography (ERCP), the treatment options after failed ERP are very limited. Therefore, endoscopic ultrasound (EUS)-guided access to the PD and options for subsequent drainage may play an important role as an alternative to surgical intervention. However, this approach is technically demanding with a high risk of complications, and should only be performed by highly experienced endoscopists. In this review, we describe an overview of the current endoscopic approaches, basic technical tips, and outcomes using these procedures.

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“…Common indications include stenosis of the PJ with or without pancreatic fistula (seen in 30% to 50% of patients who have undergone the Whipple procedure) [57-59], PD stricture or stones in chronic pancreatitis, main pancreatic duct (MPD) disruption, and failed endoscopic retrograde pancreatography (ERP). Overall, EUS-guided pancreatic duct drainage (EUS-PD) has been associated with lower success (69%) and higher complication rates (42.9%) than EUS-BD, although recent multicenter international retrospective studies suggested improved rates of success (>90% technical and 81%–88% clinical success) [60,61]. Of note, 63% of the patients in these recent studies had SAA.…”

Section: Therapeutic Eusmentioning

confidence: 99%

“…Stent dysfunction in over 50% of patients is the predominant concern during long-term follow-up [77,78]. A recent international multicenter retrospective study of 66 patients post-Whipple compared 40 EUS-PD procedures to 35 enteroscopy-assisted ERPs [61]. Both technical and clinical success was superior with the EUS approach (88%–93% vs. 20%–23%), although complications were also greater (35% vs. 3%).…”

Section: Therapeutic Eusmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Pancreatobiliary Endoscopy in Surgically Altered Anatomy

Jirapinyo

Lee

2016

Clin Endosc

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Endoscopic retrograde cholangiopancreatography (ERCP) has become the mainstay of therapy for pancreatobiliary diseases. While ERCP is safe and highly effective in the general population, the procedure remains challenging or impossible in patients with surgically altered anatomy (SAA). Endoscopic ultrasound (EUS) allows transmural access to the bile or pancreatic duct (PD) prior to ductal drainage using ERCP-based techniques. Also known as endosonography-guided cholangiopancreatography (ESCP), the procedure provides multiple advantages over overtube-assisted enteroscopy ERCP or percutaneous or surgical approaches. However, the procedure should only be performed by endoscopists experienced in both EUS and ERCP and with the proper tools. In this review, various EUS-guided diagnostic and therapeutic drainage techniques in patients with SAA are examined. Detailed step-by-step procedural descriptions, technical tips, feasibility, and safety data are also discussed.

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An international multicenter study comparing EUS-guided pancreatic duct drainage with enteroscopy-assisted endoscopic retrograde pancreatography after Whipple surgery

Cited by 116 publications

References 26 publications

Consensus guidelines on the optimal management in interventional EUS procedures: results from the Asian EUS group RAND/UCLA expert panel

Consensus guidelines on the optimal management in interventional EUS procedures: results from the Asian EUS group RAND/UCLA expert panel

Endoscopic Ultrasound-Guided Pancreatic Duct Intervention

Endoscopic Ultrasound-Guided Pancreatobiliary Endoscopy in Surgically Altered Anatomy

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