EUS-guided transanastomotic drainage for severe biliopancreatic anastomotic stricture using a forward-viewing echoendoscope in patients with surgically altered anatomy.
Endosc Ultrasound
; 10(1): 33-38, 2021.
Article
in En
| MEDLINE
| ID: mdl-33473043
ABSTRACT
BACKGROUND AND OBJECTIVES:
Balloon enteroscopy-assisted ERCP (BE-ERCP) has become the first-line therapy for biliopancreatic anastomotic strictures. However, it is not always successful, and salvage methods have not been established. This study aimed to evaluate the outcomes of EUS-guided transanastomotic drainage using a forward-viewing (FV) echoendoscope. PATIENTS ANDMETHODS:
Of eight cases wherein BE-ERCP treatment failed due to severe or complete benign anastomotic stricture, seven cases underwent EUS-guided choledochojejunostomy, and EUS-guided pancreaticojejunostomy was applied in one case after intubating an FV echoendoscope into the anastomotic site.RESULTS:
The success rate of reaching the target site was 100% (8/8) for patients after modified Child resection. The median time to reach the anastomosis was 5 min (range 3-17 min), and the technical success rate for drainage was 75% (6/8). The median total procedure time was 33.5 min (range 22-45 min) for six successful cases. Cautery dilatation catheters were necessary to dilate the puncture site in all cases, and no early complications were observed. During the follow-up period (median 13.3 months [range 6.5-60.3]), recurrence of the stricture occurred in one case, and a stent-free status was achieved after 6-12 months of stent placement in five cases.CONCLUSIONS:
EUS-guided transanastomotic drainage using an FV echoendoscope is a feasible and safe rescue technique for the management of benign severe biliopancreatic anastomotic strictures.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Endosc Ultrasound
Year:
2021
Document type:
Article
Affiliation country: