EUS-guided pancreaticogastrostomy.
BACKGROUND
The pain of chronic pancreatitis can be caused by pancreatic ductal hypertension, and endoscopic drainage of the main pancreatic duct can provide relief. When transpapillary access to a dilated portion of the main duct cannot be obtained, conventional endoscopic drainage is not possible. The use of interventional EUS to perform a pancreaticogastrostomy in such cases is described.


METHODS
Four patients presented with pain and a dilated main pancreatic duct proximal to a complete obstruction. EUS was used to access the dilated duct and create a pancreaticogastrostomy. Patency of the latter was maintained by placement of a pancreaticogastric stent.


METHODS
EUS-guided pancreaticogastrostomy was performed without major complication. Three of 4 patients had satisfactory relief of pain at a median follow-up of 1 year.


CONCLUSIONS
EUS-guided pancreaticogastrostomy may be a promising new technique for pancreatic drainage and pain relief when conventional transpapillary access to the pancreatic duct is not possible.
François
Erik
E
Department of Gastroenterology, Hôpital Erasme, Brussels, Belgium.
Kahaleh
Michel
M
Giovannini
Marc
M
Matos
Celso
C
Devière
Jacques
J
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D019160:Endosonography; D005260:Female; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000601:surgery*