| Theme |
Progress in Endoscopic Ultrasonography for Biliopancreatic Diseases |
| Title |
EUS—guided Pancreatic Duct Drainage |
| Author |
Akio Katanuma |
Center for Gastroenterology, Teine‒Keijinkai Hospital |
| Author |
Toshifumi Kin |
Center for Gastroenterology, Teine‒Keijinkai Hospital |
| Author |
Kei Yane |
Center for Gastroenterology, Teine‒Keijinkai Hospital |
| Author |
Kazumasa Nagai |
Center for Gastroenterology, Teine‒Keijinkai Hospital |
| Author |
Kazunari Tanaka |
Center for Gastroenterology, Teine‒Keijinkai Hospital |
| Author |
Hiroyuki Maguchi |
Center for Gastroenterology, Teine‒Keijinkai Hospital |
| [ Summary ] |
Pancreatic ductal hypertension associated with several pancreatic conditions, including chronic pancreatitis, pancreatic duct stones, and stenosis of the anastomotic site after pancreaticoenterostomy, cause epigastric and back pain. Endoscopic drainage of the main pancreatic duct, using a duodenoscope or enteroscope, is an effective treatment to relieve these symptoms. However, sometimes difficult cases were encountered using conventional endoscopic procedures because of tight stricture, stones, or anatomical reasons after operation.
Recently, endoscopic ultrasound (EUS)‒guided interventions have become more common and EUS‒guided pancreatic duct access is reported as an alternative approach method after conventional endoscopic procedures have failed. Drainage of an obstructed pancreatic duct under EUS guidance has evolved into viable techniques suitable for patients with failed ERCP and/or altered surgical anatomy. 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‒guided pancreatic duct drainage (EUS‒PD) is an effective salvage method, the technique is not always successful and often fails, even were performed by skilled endosonographers. Therefore, we should consider the indications and contraindications of EUS‒PD. |