Endoscopic Ultrasound-Guided Pancreatic Duct Drainage: Techniques and Literature Review of Transmural Stenting
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Endoscopic ultrasound-guided pancreatic duct drainage (EUS-PD) has emerged as an option in patients with failure of retrogradeaccess to the pancreatic duct (PD) because of difficulty in cannulation or surgically altered anatomy. This article provides acomprehensive review of the techniques and outcomes of EUS-PD, especially EUS-guided pancreatic transmural stenting. Theclinical data derived from a total of 401 patients were reviewed in which the overall technical and clinical success rates were 339/401(85%, range 63%–100%) and 328/372 (88%, range 76%–100%), respectively. Short-term adverse events occurred in 25% (102/401) ofthe cases, which included abdominal pain (n=45), acute pancreatitis (n=17), bleeding (n=10), and issues associated with pancreaticjuice leakage such as perigastric or peripancreatic fluid collection (n=9). In conclusion, although EUS-PD remains a challengingprocedure with a high risk of adverse events such as pancreatic juice leakage, perforation, and severe acute pancreatitis, the procedureseems to be a promising alternative for PD drainage in patients with altered anatomy or unsuccessful endoscopic retrogradepancreatography.
Abstract
Endoscopic ultrasound-guided pancreatic duct drainage (EUS-PD) has emerged as an option in patients with failure of retrogradeaccess to the pancreatic duct (PD) because of difficulty in cannulation or surgically altered anatomy. This article provides acomprehensive review of the techniques and outcomes of EUS-PD, especially EUS-guided pancreatic transmural stenting. Theclinical data derived from a total of 401 patients were reviewed in which the overall technical and clinical success rates were 339/401(85%, range 63%–100%) and 328/372 (88%, range 76%–100%), respectively. Short-term adverse events occurred in 25% (102/401) ofthe cases, which included abdominal pain (n=45), acute pancreatitis (n=17), bleeding (n=10), and issues associated with pancreaticjuice leakage such as perigastric or peripancreatic fluid collection (n=9). In conclusion, although EUS-PD remains a challengingprocedure with a high risk of adverse events such as pancreatic juice leakage, perforation, and severe acute pancreatitis, the procedureseems to be a promising alternative for PD drainage in patients with altered anatomy or unsuccessful endoscopic retrogradepancreatography.
참고문헌 (30)
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