摘要
Patients with mechanical obstruction of the pancreatic duct, which can be cau sed by chronic pancreatitis, suffer from recurrent attacks of pain and inflammat ion of the pancreas. We report a novel approach using an endoscopic ultrasound- (EUS- ) assisted rendezvous technique, which allows drainage of the pancreati c duct in patients in whom primary management by transpapillary drainage during an endoscopic retrograde cholangiopancreatography (ERCP) procedure has failed. T ransgastric puncture of the pancreatic duct was performed using a 19- gauge nee dle under EUS guidance, and a 0.035- inch guide wire was introduced into the du ct and advanced through the papilla. This wire was pulled into the duodenum usin g a side- viewing duodenoscope. A papillotomy was performed using the standard technique and a plastic prosthesis was introduced. The patient tolerated the int ervention well and was discharged with no further complaints. EUS- assisted dra inage of the pancreatic duct using a rendezvous technique is an elegant and feas ible minimally invasive endoscopic treatment for symptomatic patients with chron ic pancreatitis, in whom transpapillary introduction of a catheter is not possib le.
Patients with mechanical obstruction of the pancreatic duct, which can be cau sed by chronic pancreatitis, suffer from recurrent attacks of pain and inflammat ion of the pancreas. We report a novel approach using an endoscopic ultrasound- (EUS- ) assisted rendezvous technique, which allows drainage of the pancreati c duct in patients in whom primary management by transpapillary drainage during an endoscopic retrograde cholangiopancreatography (ERCP) procedure has failed. T ransgastric puncture of the pancreatic duct was performed using a 19- gauge nee dle under EUS guidance, and a 0.035- inch guide wire was introduced into the du ct and advanced through the papilla. This wire was pulled into the duodenum usin g a side- viewing duodenoscope. A papillotomy was performed using the standard technique and a plastic prosthesis was introduced. The patient tolerated the int ervention well and was discharged with no further complaints. EUS- assisted dra inage of the pancreatic duct using a rendezvous technique is an elegant and feas ible minimally invasive endoscopic treatment for symptomatic patients with chron ic pancreatitis, in whom transpapillary introduction of a catheter is not possib le.
