Endoscopic ultrasound-guided antegrade stone removal in a patient with pancreatic stones and anastomotic stricture after end-to-side pancreaticojejunostomy

Hisa, Takeshi; Momoi, Tamaki; Shimizu, Takeshi; Furutake, Masayuki; Takamatsu, Masato; Ohkubo, Hiroki

doi:10.1016/j.pan.2013.03.012

Cited by 9 publications

(6 citation statements)

References 9 publications

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“…Although different aforementioned techniques have been proposed over the years to perform biliopancreatic endoscopy in altered anatomy, improving technical success still needs some implementation and alternatives. Therefore, EUS-guided or assisted procedures to perform ERCP are increasing and many case reports without routine solutions have been reported over the years [ 55 , 56 , 57 , 58 , 59 ], both to get access to the biliary limb and for directly performing the procedure. Recently, a water-filled diagnostic and therapeutic EUS procedure has been proposed for patients with Billroth II or Roux-en-Y reconstruction, in order to achieve a higher success rate and lower adverse event rate, but few cases are described in literature to properly understand its efficacy [ 60 ].…”

Section: Resultsmentioning

confidence: 99%

Biliopancreatic Endoscopy in Altered Anatomy

Tarantino

Rizzo

2021

Medicina

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Background and Objectives: Anatomical post-surgical alterations of the upper gastrointestinal (GI) tract have always been challenging for performing diagnostic and therapeutic endoscopy, especially when biliopancreatic diseases are involved. Esophagectomy, gastrectomy with various reconstructions and pancreaticoduodenectomy are among the most common surgeries causing upper GI tract alterations. Technological improvements and new methods have increased the endoscopic success rate in these patients, and the literature has been rapidly increasing over the past few years. The aim of this systematic review is to identify evidence on the available biliopancreatic endoscopic techniques performed in the altered post-surgical anatomy of upper GI tract. Materials and Methods: We performed a systematic search of PubMed, MEDLINE, Cochrane Library, and SCOPUS databases. Study-level variables extracted were the last name of the first author, publication year, study design, number of patients, type of post-surgical anatomical alteration, endoscopic technique, success rate and endoscopic-related adverse events. Results: Our primary search identified 221 titles, which was expanded with studies after the citation search. The final full-text review process identified 52 articles (31 retrospective studies, 8 prospective studies and 13 case reports). We found several different techniques developed over the years for biliopancreatic diseases in altered anatomy, in order to perform both endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). They included enteroscopy-assisted ERCP (double and single balloon enteroscopy-ERCP, spiral enteroscopy-ERCP) laparoscopic assisted ERCP, EUS-Directed transgastric ERCP, EUS-directed transgastric intervention, gastric access temporary for endoscopy, and percutaneous assisted trans prosthetic endoscopic therapy. The success rate was high (most of the techniques showed a success rate over 90%) and a low rate of adverse events were reported. Conclusions: We suggest the considerationof the novel techniques when approaching patients with altered anatomy who require biliopancreatic endoscopy, focusing on the surgery type, success rate and adverse events reported in the literature.

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Section: Resultsmentioning

confidence: 99%

Biliopancreatic Endoscopy in Altered Anatomy

Tarantino

Rizzo

2021

Medicina

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“…Endoscopic intervention, which is less invasive than surgical intervention, may be another treatment of choice. Several reports have described EUS‐guided PG with pancreatic duct stenting in pancreaticodigestive tract anastomotic stricture after PD 18‐21 . However, this procedure is technically challenging and has a success rate of only ~50% 18 .…”

Section: Discussionmentioning

confidence: 99%

“…Several reports have described EUS‐guided PG with pancreatic duct stenting in pancreaticodigestive tract anastomotic stricture after PD. 18 , 19 , 20 , 21 However, this procedure is technically challenging and has a success rate of only ~50%. 18 Moreover, its long‐term efficacy has not yet been reported.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Pancreaticojejunostomy for Pancreaticodigestive Tract Anastomotic Stricture After Pancreaticoduodenectomy

Matsumoto

Kamei

Kawaguchi

et al. 2021

Annals of Gastroent Surgery

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“… 4 Even with transmural drainage, mean technical success may not be superior to 82%, possibly due to lack of a dedicated pancreatic stent designed for EUS-guided placement. 5 Transmural drainage may be performed from the gastric 6 7 or jejunum side. 8 9 Even in cases where it is possible to reach the pancreaticojejunal anastomosis, retrograde pancreatic stent placement may be associated with difficulties in creating and dilating the fistula, when using a conventional echoendoscope.…”

Section: Case Reportmentioning

confidence: 99%

Gastro-pancreaticojejunostomy for treatment of pancreatic ductal obstruction in a post-Whipple procedure patient

Rodrigues‐Pinto

Grimm

Baron³

2015

BMJ Open Gastroenterol

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We report a case of a woman with a medical history of classic Whipple surgery who underwent endoscopic ultrasound (EUS)-guided pancreatic drainage due to smouldering acute pancreatitis secondary to an obstructing pancreatic ductal stone. A gastro-pancreaticojejunostomy anastomosis was created anterogradely, with dilation of both the anastomoses in the same procedure, with subsequent decompression of the pancreatic duct. Endoscopic retrograde pancreatography (ERP) is often impossible to perform in patients with post-Whipple procedure anatomy due to inaccessibility to the pancreaticojejunostomy anastomosis. EUS-guided pancreatic drainage may be offered in these patients in whom the pancreatic duct cannot be accessed at ERP. It has been used as a platform for access to and drainage of the pancreatic duct either by rendezvous or transmural drainage. However, only one of four patients achieve successful completion of the rendezvous procedure. There are limited data regarding safety and long-term outcome of this procedure, as well as scant guidelines on the optimal time for leaving stents in place. We believe definitive endoscopic therapy should be attempted, whenever possible, after relief of obstruction. In our case, we expect that stent occlusion is inevitable and that long-term drainage is possible due to drainage occurring between the stent and the stone.

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Endoscopic ultrasound-guided antegrade stone removal in a patient with pancreatic stones and anastomotic stricture after end-to-side pancreaticojejunostomy

Cited by 9 publications

References 9 publications

Biliopancreatic Endoscopy in Altered Anatomy

Biliopancreatic Endoscopy in Altered Anatomy

Longitudinal Pancreaticojejunostomy for Pancreaticodigestive Tract Anastomotic Stricture After Pancreaticoduodenectomy

Gastro-pancreaticojejunostomy for treatment of pancreatic ductal obstruction in a post-Whipple procedure patient

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