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Technical tips for endoscopic ultrasound-guided pancreatic duct access and drainage

Nakai Yousuke,
소속 상세정보
 ( Nakai Yousuke ) - University of Tokyo Graduate School of Medicine Department of Gastroenterology

Abstract


Endoscopic ultrasound (EUS)-guided pancreatic duct access and drainage can be achieved by EUS-guided rendezvous (EUS-RV) or EUS-guided pancreatic duct drainage (EUS-PD) by transmural stent placement. Although the procedure is utilized for further complex treatment such as intraductal lithotripsy in obstructive pancreatic duct stones, the procedure is technically difficult compared to other EUS-guided interventions. Recently, some devices are developed for EUS-guided pancreatic duct intervention. In this review, technical tips are reviewed in a step-by-step fashion from puncture, guidewire insertion, tract dilation to drainage. Given the advantage of EUS-guided approach, treatment algorithm of endotherapy for pancreatic indications should be further established especially in cases with surgically altered anatomy.

키워드

Endoscopic ultrasound; Pancreatic duct obstruction; Rendezvous; Transmural drainage

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