Endoscopic ultrasound-guided transluminal drainage of pancreatic duct obstruction: long-term outcome

Ergun, Meltem; Aouattah, Tarik; Gillain, Cédric; Jf, Gigot; Hubert, Catherine; Deprez, Pierre Henri

doi:10.1055/s-0030-1256333

Cited by 118 publications

(75 citation statements)

References 23 publications

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“…Tessier et al reported stent dysfunction in 55% (20/26) of patients that required a total of 29 repeat endoscopies [7]. Similarly, Ergun et al reported stent dysfunction in 50% of patients (9/18) during a median follow-up of 37 months [15]. Fujii et al described stent dysfunction in eight patients (25%) with migration in five and occlusion in three [8].…”

Section: Technical Success Outcomes and Complicationsmentioning

confidence: 96%

“…The initial approach was reported by Bataille et al who created a pancreaticoenteric fistula with antegrade wire passage to facilitate the subsequent rendezvous with retrograde stent insertion [9]. Subsequently, others provided drainage via creation of a pancreaticogastric fistula with antegrade stent insertion [8,[10][11][12][13][14][15][16][17][18]. EUSguided pancreaticoduodenostomy is a more recently described technique used in patients with either acute or chronic pancreatitis and allows access to the MPD from the duodenal bulb [12].…”

Section: Techniquementioning

confidence: 99%

“…Barkay et al 2010 [31] Retrograde TP/TA (n = 10) 10/21 Peripancreatic abscess (n = 1) Pancreatitis (n = 1) Shaving of guidewire coating (n = 1) Ergun et al 2011 [15] Retrograde TP/TA (n = 5) Transluminal (n = 13)…”

Section: /8 Nonementioning

confidence: 99%

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Endoscopic ultrasound‐guided pancreatic duct drainage

Fujii-Lau

Levy

2014

J Hepato Biliary Pancreat

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Endoscopic ultrasound (EUS) has evolved from a purely diagnostic procedure to one with therapeutic capabilities. One of the most challenging therapeutic intervention for endosonographers is EUS-guided pancreatic drainage. The development of this technique has allowed access and drainage of the main pancreatic duct after failed endoscopic retrograde pancreatography and can avoid invasive procedures such as surgical and percutaneous interventions. This review discusses the indications, technique, challenges, and an algorithmic approach to EUS-guided pancreatic drainage.

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Section: Technical Success Outcomes and Complicationsmentioning

confidence: 96%

Section: Techniquementioning

confidence: 99%

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Endoscopic ultrasound‐guided pancreatic duct drainage

Fujii-Lau

Levy

2014

J Hepato Biliary Pancreat

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“…After median follow-up of 37 months, 72% of patients achieved pain control. 57 A retrospective study by Fujii et al 58 reported their single center experience in 43 patients. This report showed an overall technical success of 74% and complete symptom resolution was reported in 83% of cases.…”

Section: Eus-guided Pancreatic Duct Drainagementioning

confidence: 99%

Advances in endotherapy in chronic pancreatitis

Coronel

DaVee

Lee

2017

Int J Gastrointest Interv

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Patients with chronic pancreatitis may develop complications such as chronic debilitating abdominal pain related to neuropathy, pancreatic duct leaks, pseudocysts, pancreatic carcinoma, pancreatic duct calcifications and strictures. Management of mechanical complications of chronic pancreatitis may pose a significant challenge to the interventional endoscopist. The purpose of this manuscript is to explore the latest developments in interventional techniques and to set the stage for future investigations.

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“…EUS-PG may be useful when transpapillary access is unavailable. However, various complications can occur, such as pancreatitis [1,2]. Guidewire shearing is not uncommon and is regarded as a serious, reportable adverse event [3,4] that can lead to complications.…”

mentioning

confidence: 99%

Fluoroscopically guided removal of a retained sheared guidewire following failed endoscopic ultrasound-guided pancreatic duct drainage

Jung

Lee

et al. 2015

Endoscopy

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A 50-year-old man with a retained sheared guidewire in the main pancreatic duct and pancreatic parenchyma was referred for recurrent pancreatitis. He had previously undergone a pancreaticoduodenectomy for pancreatic hemangioma and was experiencing recurrent pancreatitis due to pancreaticojejunostomy stricture. Endoscopic ultrasound-guided pancreaticogastrostomy (EUS-PG) had been attempted at another hospital. However, this procedure had failed, and part of a 0.035-in guidewire (Roadrunner; Cook Medical, Bloomington, Indiana, USA) was retained in the pancreatic duct and pancreatic parenchyma (• " Fig. 1). At our hospital, EUS-PG revealed a stricture in the pancreaticojejunostomy through which the guidewire could not pass. A fully covered, self-expandable metal stent, 6 mm in diameter and 8 cm in length (M. I. Tech, Seoul, Korea) was placed at EUS-PG. The patient was readmitted for removal of the retained guidewire and stent revision 6 weeks after the transmural stenting. After removal of the metal stent, pancreatography conducted through the fistula showed a decompressed pancreatic duct. Because the tract had matured as a result of use of the metal stent, a rat-tooth grasping forceps (FG-8L-1; Olympus, Tokyo, Japan) could move freely through the pancreatic duct under fluoroscopic guidance with a 0.025-in guidewire placed through the PJ stricture. The retained guidewire was successfully grasped with the forceps and removed (• " Fig. 2). The stricture in the pancreaticojejunostomy was managed with balloon dilation and transmural and transanastomotic placement of a 7-Fr double-pigtail plastic stent. EUS-PG may be useful when transpapillary access is unavailable. However, various complications can occur, such as pancreatitis [1, 2]. Guidewire shearing is not uncommon and is regarded as a serious, reportable adverse event [3, 4] that can lead to complications. In the current case, EUS-guided pancreatic drainage with a fully covered, self-expandable metal stent allowed opening of the high profile fistula and pancreatic duct for simultaneous removal of the retained guidewire and treatment of the pancreaticojejunostomy stricture. This case may help with the future management of guidewire shearing complications associated with EUS-guided procedures for drainage of the pancreatic duct.

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Endoscopic ultrasound-guided transluminal drainage of pancreatic duct obstruction: long-term outcome

Abstract: Technical success rate of EUS-PD and clinical long-term pain resolution were 90 % and 72 %, respectively. EUS-PD is a reliable procedure with a low complication rate. It might therefore replace surgery at expert centers.

Cited by 118 publications

References 23 publications

Endoscopic ultrasound‐guided pancreatic duct drainage

Endoscopic ultrasound‐guided pancreatic duct drainage

Advances in endotherapy in chronic pancreatitis

Fluoroscopically guided removal of a retained sheared guidewire following failed endoscopic ultrasound-guided pancreatic duct drainage

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