title: Endoscopic ultrasonography-guided pancreaticogastrostomy for a case of occlusion of gastro-pancreatic anastomosis after pancreaticoduodenectomy.
abstract: BACKGROUND
  EUS-guided pancreaticogastrostomy is described as an alternative to surgery for ductal decompression when endoscopic transpapillary access is impossible. We report a case where EUS-guided pancreaticogastrostomy of the pancreatic duct was effective for dilatation of the pancreatic duct caused from occlusion of gastro-pancreatic anastomosis constructed after resection of pancreaticoduodenectomy.
  
  
  METHODS
  The patient was a 79-year-old woman who had undergone operation for IPMN in the pancreatic head in 1998. Nine years after the operation, she visited us for back pain, and conspicuous dilatation of the main pancreatic duct was found. By observing curved liner array EUS scope, we successfully punctured the main pancreatic duct and placed a plastic stent.
  
  
  RESULTS
  After the treatment, the subjective symptom was alleviated and reduction of the dilatation of pancreatic duct was observed in image findings.
  
  
  CONCLUSIONS
  Endoscopic ultrasonography guided pancreaticogastrostomy appears to be an effective treatment for a case of occlusion of gastro-pancreatic anastomosis after pancreaticoduodenectomy.
authors.affiliation: Center for Gastroenterology, Teine Keijin-kai Hospital, Sapporo, Japan. akio-ka@ta2.so-net.ne.jp
authors.forename: Akio
authors.initials: A
authors.lastname: Katanuma
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Maguchi
authors.forename: Mituharu
authors.initials: M
authors.lastname: Fukazawa
authors.forename: Akira
authors.initials: A
authors.lastname: Kurita
authors.forename: Tamaki
authors.initials: T
authors.lastname: Ichiya
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Kin
authors.forename: Manabu
authors.initials: M
authors.lastname: Osanai
authors.forename: Kuniyuki
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000601:surgery*; D000368:Aged; D000714:Anastomosis, Surgical; D019160:Endosonography; D005260:Female; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D018084:Ultrasonography, Interventional