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Endoscopic ultrasonography-guided pancreatic duct drainage after failed endoscopic retrograde cholangiopancreatography in patients with malignant and benign pancreatic duct obstructions.
Dig Endosc. 2013 May; 25 Suppl 2:109-16.DE

Abstract

BACKGROUND

Endoscopic ultrasonography (EUS)-guided pancreatic drainage has been advocated as a rescue treatment for management of patients in whom retrograde access to the pancreatic duct (PD) is technically unsuccessful. The aim of the present study was to evaluate the feasibility and efficacy of EUS-guided drainage for failed endoscopic retrograde cholangiopancreatography.

PATIENTS AND METHODS

A total of 17 EUS-guided PD drainage (EUS-PD) procedures were carried out in 14 patients (age: mean 64.6 years, range 54-81 years, eight men).

RESULTS

The rendezvous technique was successful in 11 of 17 procedures (64.7%). Three of five patients with an unsuccessful rendezvous technique successfully underwent EUS-PD stenting (7-Fr plastic stent [two cases], 5-Fr endoscopic nasobiliary drainage [one case]). In the two remaining patients, puncture and pancreatography were successful; however, antegrade passage of the guidewire failed.

CONCLUSION

EUS-guided decompression of PD is a feasible and effective treatment for the management of symptomatic high-pressure PD due to stricture of the PD and/or stenotic pancreatodigestive anastomosis. However, this procedure is technically challenging, has a high rate of complications, and should be done only at tertiary-care centers.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. kurihara@tokyo-med.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

23617660

Citation

Kurihara, Toshio, et al. "Endoscopic Ultrasonography-guided Pancreatic Duct Drainage After Failed Endoscopic Retrograde Cholangiopancreatography in Patients With Malignant and Benign Pancreatic Duct Obstructions." Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society, vol. 25 Suppl 2, 2013, pp. 109-16.
Kurihara T, Itoi T, Sofuni A, et al. Endoscopic ultrasonography-guided pancreatic duct drainage after failed endoscopic retrograde cholangiopancreatography in patients with malignant and benign pancreatic duct obstructions. Dig Endosc. 2013;25 Suppl 2:109-16.
Kurihara, T., Itoi, T., Sofuni, A., Itokawa, F., & Moriyasu, F. (2013). Endoscopic ultrasonography-guided pancreatic duct drainage after failed endoscopic retrograde cholangiopancreatography in patients with malignant and benign pancreatic duct obstructions. Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society, 25 Suppl 2, 109-16. https://doi.org/10.1111/den.12100
Kurihara T, et al. Endoscopic Ultrasonography-guided Pancreatic Duct Drainage After Failed Endoscopic Retrograde Cholangiopancreatography in Patients With Malignant and Benign Pancreatic Duct Obstructions. Dig Endosc. 2013;25 Suppl 2:109-16. PubMed PMID: 23617660.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic ultrasonography-guided pancreatic duct drainage after failed endoscopic retrograde cholangiopancreatography in patients with malignant and benign pancreatic duct obstructions. AU - Kurihara,Toshio, AU - Itoi,Takao, AU - Sofuni,Atsushi, AU - Itokawa,Fumihide, AU - Moriyasu,Fuminori, PY - 2012/12/01/received PY - 2013/02/07/accepted PY - 2013/4/27/entrez PY - 2013/5/3/pubmed PY - 2014/1/8/medline SP - 109 EP - 16 JF - Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society JO - Dig Endosc VL - 25 Suppl 2 N2 - BACKGROUND: Endoscopic ultrasonography (EUS)-guided pancreatic drainage has been advocated as a rescue treatment for management of patients in whom retrograde access to the pancreatic duct (PD) is technically unsuccessful. The aim of the present study was to evaluate the feasibility and efficacy of EUS-guided drainage for failed endoscopic retrograde cholangiopancreatography. PATIENTS AND METHODS: A total of 17 EUS-guided PD drainage (EUS-PD) procedures were carried out in 14 patients (age: mean 64.6 years, range 54-81 years, eight men). RESULTS: The rendezvous technique was successful in 11 of 17 procedures (64.7%). Three of five patients with an unsuccessful rendezvous technique successfully underwent EUS-PD stenting (7-Fr plastic stent [two cases], 5-Fr endoscopic nasobiliary drainage [one case]). In the two remaining patients, puncture and pancreatography were successful; however, antegrade passage of the guidewire failed. CONCLUSION: EUS-guided decompression of PD is a feasible and effective treatment for the management of symptomatic high-pressure PD due to stricture of the PD and/or stenotic pancreatodigestive anastomosis. However, this procedure is technically challenging, has a high rate of complications, and should be done only at tertiary-care centers. SN - 1443-1661 UR - https://www.unboundmedicine.com/medline/citation/23617660/Endoscopic_ultrasonography_guided_pancreatic_duct_drainage_after_failed_endoscopic_retrograde_cholangiopancreatography_in_patients_with_malignant_and_benign_pancreatic_duct_obstructions_ L2 - https://doi.org/10.1111/den.12100 DB - PRIME DP - Unbound Medicine ER -