Percutaneous Pancreatic Stent Placement for Postoperative Pancreaticojejunostomy Stenosis: A Case Report

Abstract

Stenosis of the pancreatico-enteric anastomosis is one of the major complications of pancreaticoduodenectomy (PD). Endoscopic stent placement, has limited success rate as a nonsurgical treatment due to altered gastrointestinal anatomy. Percutaneous treatment is rarely attempted due to the technical difficulty in accessing the pancreatic duct. We reported a case of pancreaticojejunostomy stenosis after PD, in which a pancreatic stent was successfully placed using a rendezvous technique with a dual percutaneous approach.

Percutaneous Image-Guided Pancreatic Duct Drainage: Technique, Results and Expected Benefits

“…This leads to enhanced safety and ease in locking the loop of the drain (to get the "Pig-Tail" condition of the drainage catheter tip) (44) (45). In addition, PD tail puncture also facilitates easier inception of the longer introduction sheath, which mollifies the technical demands of the second line procedures, performed using different type 4 or 5 Fr advancement catheters.…”

Surgical revision for pancreatojejunostomy stricture: a case series of 14 patients

“…Unfortunately, important diagnostic criteria, such as accurate measurement of MPD dilation and assessment of exocrine function of the pancreas, were not taken into consideration in various published reports. Several management modalities have been described for the treatment of PJS, including percutaneous puncture-guided CT, endoscopy, surgery, and laser dissection [2,4,12,27]. Nevertheless, there is no broad consensus regarding the therapeutic strategies for PJS.…”

“…PJS is a rare and long-term complication of pancreatic surgery. Owing to its rarity, most of the available literature is limited to case-reports [1][2][3]. Recently, surgical techniques and the understanding of pancreatic diseases have tremendously improved.…”

“…Abdominal pain or distention, recurrent acute pancreatitis, and signs of pancreatic endocrine or exocrine insufficiency constitute the major complaints of PJS [5,10,11]. Various treatment modalities have been reported for the management of symptomatic PJS, including endoscopic balloon dilatation, robotic surgical revision, percutaneous puncture dilatation, and laser dissection of stricture tissue [2,[12][13][14]. Here, we analyzed the perioperative, postoperative, and follow-up data from a cohort of patients with PJS managed by open surgical revision at a high-volume pancreatic center.…”

Successful Surgical Removal of Firmly Impacted Pancreatic Duct Stent: Two Case Report

“…Pancreatic stents are used for a variety of different pancreatic disorders: pancreatic duct stones, chronic pancreatitis, pancreatic strictures, unresectable pancreatic cancer, preventing POPF and post-ERCP pancreatitis, papillary adenoma [1][2][3][4][5][6][7][8]. Conventionally the pancreatic duct stents placement are done by endoscopic transpapillary procedure, but recently there are increasingly more reports of feasibility of percutaneous imageguided pancreatic duct (PD) drainage and stenting ,which appears to be a safe and effective procedures, but it should be noted that these procedures also are not without any complications and may have some adverse events [9][10][11][12][13][14]23,24]. Two cases of firmly impacted pancreatic stents removal recently observed in our institution led us to report our experience of successful management of these particular cases.…”