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ENDOSCOPIC ULTRASONOGRAPHY‐GUIDED PANCREATICOGASTROSTOMY FOR A CASE OF OCCLUSION OF GASTRO‐PANCREATIC ANASTOMOSIS AFTER PANCREATICODUODENECTOMY
Author(s) -
Katanuma Akio,
Maguchi Hiroyuki,
Fukazawa Mituharu,
Kurita Akira,
Ichiya Tamaki,
Kin Toshifumi,
Osanai Manabu,
Takahashi Kuniyuki
Publication year - 2009
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2009.00854.x
Subject(s) - medicine , pancreaticoduodenectomy , pancreatic duct , anastomosis , surgery , occlusion , radiology , endoscopic ultrasonography , endoscopy , resection , pancreatitis
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. Patients and 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. Conclusion: Endoscopic ultrasonography guided pancreaticogastrostomy appears to be an effective treatment for a case of occlusion of gastro‐pancreatic anastomosis after pancreaticoduodenectomy.