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Endoscopic Ultrasound-Guided Pancreatic Duct Drainage: Techniques and Literature Review of Transmural Stenting

Clinical Endoscopy 2020년 53권 5호 p.525 ~ 534
Imoto Akira, Ogura Takeshi, Higuchi Kazuhide,
소속 상세정보
 ( Imoto Akira ) - Aoyama Hospital
 ( Ogura Takeshi ) - Osaka Medical College Department of Internal Medicine
 ( Higuchi Kazuhide ) - Osaka Medical College Department of Internal Medicine

Abstract


Endoscopic ultrasound-guided pancreatic duct drainage (EUS-PD) has emerged as an option in patients with failure of retrograde access to the pancreatic duct (PD) because of difficulty in cannulation or surgically altered anatomy. This article provides a comprehensive review of the techniques and outcomes of EUS-PD, especially EUS-guided pancreatic transmural stenting. The clinical data derived from a total of 401 patients were reviewed in which the overall technical and clinical success rates were 339/401 (85%, range 63%?100%) and 328/372 (88%, range 76%?100%), respectively. Short-term adverse events occurred in 25% (102/401) of the cases, which included abdominal pain (n=45), acute pancreatitis (n=17), bleeding (n=10), and issues associated with pancreatic juice leakage such as perigastric or peripancreatic fluid collection (n=9). In conclusion, although EUS-PD remains a challenging procedure with a high risk of adverse events such as pancreatic juice leakage, perforation, and severe acute pancreatitis, the procedure seems to be a promising alternative for PD drainage in patients with altered anatomy or unsuccessful endoscopic retrograde pancreatography.

키워드

Drainage; Endoscopic ultrasound; Pancreatic; Post-surgery; Stent

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