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Endoscopic retrograde cholangiopancrea− tography (ERCP) showed contrast extrava− sation at the end of the pancreatic duct. Pancreatic endoscopic sphincterotomy and pancreaticoduodenal stent place− ment and conservative therapy failed. Percutaneous drainage was judged to be impossible. An endoscopic ultrasound (EUS)−guided cystogastrostomy [1] was carried out, including balloon dilation and placement of two 7−Fr double−pigtail stents, followed by endoscopic retrograde pancreatography (ERP) to visualize the pancreatic duct and leakage from the end of it (Figure 1). A coil (for intravascular use ± a fibered platinum coil, 0.035 inches in diameter, straight length 50 mm, coiled size 5  4 mm; Target Vascular, Boston Sci− entific, Ireland) was preloaded into an ERCP catheter and then deployed (Fig− ure 2) by advancing a 0.035−inch wire un− der guidance with fluorescence. In its fi− nal position, the coil partly returned to its preset shape and remained firmly in place (Figure 3).

Permanent closure of a pancreatic duct leak by endoscopic coiling