EUS–guided pancreaticogastrostomy: analysis of its efficacy to drain inaccessible pancreatic ducts

Kahaleh, Michel; Hernandez, A.; Tokar, Jeffrey L.; Adams, Reid B.; Shami, Vanessa M.; Yeaton, Paul

doi:10.1016/j.gie.2006.05.008

Cited by 186 publications

(122 citation statements)

References 36 publications

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“…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%

“…These data suggest that patients may benefit from routine stent exchange, particularly if they require prolonged stent duration. [11,13] TP [7] Transluminal (n = 33) 33/36 Bleeding (n = 1) Acute pancreatitis (n = 1) Unspecified mild complication (n = 3) Will et al 2007 [22] Retrograde TP/TA (n = 4) Transluminal (n = 5)…”

Section: Technical Success Outcomes and Complicationsmentioning

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: Techniquementioning

confidence: 99%

Section: Technical Success Outcomes and Complicationsmentioning

confidence: 99%

Endoscopic ultrasound‐guided pancreatic duct drainage

Fujii-Lau

Levy

2014

J Hepato Biliary Pancreat

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“…Discussion EUS-guided identification and puncture of the pancreatic duct with an enlarged calibre may circumvent the problem of an unreachable papilla of Vater, facilitate the introduction of a catheter into the papilla and allow further manipulation such as the insertion of a guide wire into the pancreatic duct (to achieve drainage of the retained or disrupted pancreatic duct [Will, 2008;Erickson, 2007;Shami and Kahaleh, 2007;Will et al 2007Will et al , 2005Kahaleh et al 2007Kahaleh et al , 2003Buscail et al 2006;Dewitt et al 2004;Mallery et al 2004;Francois et al 2002]). In agreement with the recent literature, the EUS-guided procedure represents the appropriate treatment option for several conditions.…”

Section: Resultsmentioning

confidence: 99%

“…This approach can also be considered reasonable for several indications such as chronic pancreatitis, anomalies of the congenital pancreatic or postoperative gastrointestinal and peripancreatic anatomy, providing a low periinterventional risk and avoiding more traumatic surgery [Will, 2008;Kahaleh et al 2007Kahaleh et al , 2003Shami and Kahaleh 2007;Will et al 2007Will et al , 2005. However, the procedure has some limitations and can be performed only when a dilated pancreatic duct is observed.…”

Section: Resultsmentioning

confidence: 99%

Successful transgastric pancreaticography and endoscopic ultrasound-guided drainage of a disconnected pancreatic tail syndrome

Will

Fueldner

Goldmann

et al. 2011

Therap Adv Gastroenterol

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Abstract:Objectives: We aim to demonstrate that endoscopic ultrasound (EUS)-guided transgastric pancreaticography/drainage of the pancreatic duct is feasible and successful in healing a persisting pancreaticocutaneous fistula. Methods: By means of a case report, we describe the following alternative therapeutic procedure. A 76-year-old male had: (1) 10 surgical interventions because of necrotizing acute pancreatitis with a persisting pancreaticocutaneous fistula (volume 200300 ml/day); (2) an unsuccessful attempt of transpapillary drainage (disrupted duct after necrosectomy). He then underwent a EUS-guided transluminal pancreaticography/drainage of the pancreatic duct. A transgastric puncture was performed followed by, insertion of a guide wire into the dilated tail segment, and expansion of the gastropancreaticostomy using a 10-Fr retriever. A 10-Fr Amsterdam prosthesis was then placed through the guide wire. Results: The procedure was both a technical and clinical success as indicated by fistula occlusion and sufficient internal drainage of the pancreatic juice via the gastropancreaticostomy. No severe complications such as bleeding, perforation stent occlusion or migration were observed during the 15-month follow-up. Conclusions: Transgastric pancreaticography and EUS-guided drainage of the enlarged pancreatic duct are elegant and feasible alternative options for the treatment of specific pancreatic lesions such as persisting pancreaticocutaneous fistula (complication after necrotizing pancreatitis), after pancreatic resective surgery, chronic pancreatitis and anomaly of the congenital pancreatic or postoperative gastrointestinal anatomy. Moreover, the procedure may represent a valid tool to avoid surgery and more invasive interventions.

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“…EUS-guided puncture and opacification of the pancreatic duct is performed, creating a transgastric fistula with placement of a guidewire into the main pancreatic duct and subsequent ductal decompression with a plastic endoprosthesis. The main outcome measurements used were Mean main pancreatic duct size, pain score, and weight before and after intervention [7]. Pancreatic ductal anatomy can predict the likely success of percutaneous drainage of pseudocysts of the pancreas [8].…”

Section: Introductionmentioning

confidence: 99%

Variations in the Duct System of Pancreas: A Cadaveric Study

Govindraj¹,

Shabna²

2017

IJAR

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Background: Recently there has been growing interest in the duct system of pancreas as concerns its relationship with various disease processes as well as newer investigatory and treatment modalities related to them.This study has been aimed at evaluating the anatomy of the pancreatic duct system, thus identifying the variants to improve our knowledge of it and make things easier. The pancreas is formed by the fusion of the ventral and dorsal anlage, and a wide spectrum of anomalies or anatomical variations may appear related to this complicated process of fusion: e.g., agenesis, aplasia of a pancreatic anlage, hypoplasia, annular pancreas, pancreas divisum or nonfusion of the ventral and dorsal duct system, pancreaticobiliary maljunction, etc. Every endoscopist who engages in pancreatography or related diagnostic and therapeutic procedures should always be aware of all sorts of anatomical variations he or she might encounter.

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EUS–guided pancreaticogastrostomy: analysis of its efficacy to drain inaccessible pancreatic ducts

Cited by 186 publications

References 36 publications

Endoscopic ultrasound‐guided pancreatic duct drainage

Endoscopic ultrasound‐guided pancreatic duct drainage

Successful transgastric pancreaticography and endoscopic ultrasound-guided drainage of a disconnected pancreatic tail syndrome

Variations in the Duct System of Pancreas: A Cadaveric Study

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