| Theme |
Diagnostic and Interventional EUS -- Present Status and Future Perspectives |
| Title |
Endoscopic Ultrasound-guided Pancreatic Duct Drainage |
| Author |
Akio Katanuma |
Center for Gastroenterology, Teine-Keijinkai Hospital |
| Author |
Hiroyuki Maguchi |
Center for Gastroenterology, Teine-Keijinkai Hospital |
| Author |
Kei Yane |
Center for Gastroenterology, Teine-Keijinkai Hospital |
| Author |
Toshifumi Kin |
Center for Gastroenterology, Teine-Keijinkai Hospital |
| Author |
Manabu Osanai |
Center for Gastroenterology, Teine-Keijinkai Hospital |
| Author |
Kuniyuki Takahashi |
Center for Gastroenterology, Teine-Keijinkai Hospital |
| [ Summary ] |
Pancreatic ductal hypertension, associated with various pancreatic conditions, including chronic pancreatitis, pancreatic duct stones and stenosis of the anastomotic site after pancreaticoenterostomy, causes epigastric and back pain. Endoscopic drainage of the main pancreatic duct using duodenoscopes or enteroscopes is an effective treatment to relieve symptoms. However, there may be cases where it is difficult to use conventional endoscopic procedures because of tight strictures, stones, or anatomical post-surgical characteristics.
Endoscopic ultrasonography (EUS)-guided interventions have become more common. EUS-guided pancreatic duct access is reported to be an alternative approach after conventional endoscopic procedures have failed. EUS-guided pancreatic duct intervention is divided into two types, antegrade stent placement and retrograde stent placement using rendezvous techniques, following EUS-guided pancreatography. Although EUS-PD is an effective salvage method, the procedure is not always successful and often fails even with skilled endosonographers. Therefore, we should consider the indications and contraindications of EUS-PD. |