Successful Endoscopic Treatment of Severe Pancreaticojejunostomy Strictures by Puncturing the Anastomotic Site with an EUS-guided Guidewire.

Abstract

Pancreaticojejunostomy stricture (PJS) is a late complication of pancreaticoduodenectomy. The endoscopic treatment of PJS is very challenging due to the difficulty of locating the small anastomotic site and passing the stricture using a guidewire. We herein report two cases of severe PJS. These patients could not be treated using only double-balloon endoscopy or endoscopic ultrasound-guided puncture of the main pancreatic duct because of severe stenosis at the anastomotic site. However, we could treat them by the rendezvous technique using the rigid part of the guidewire to penetrate PJS. This method was useful and safe for treating severe PJS.

• Authors: Tatsuhide Nabeshima, Atsushi Kanno, Atsushi Masamune, Hiroki Hayashi, Seiji Hongo, Naoki Yoshida, Eriko Nakano, Shin Miura, Shin Hamada, Kazuhiro Kikuta, Kiyoshi Kume, Morihisa Hirota, Michiaki Unno, Tooru Shimosegawa
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 57 Issue 3 Pg. 357-362 (Feb 01 2018) ISSN: 1349-7235 [Electronic] Japan
• PMID: 29151507 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Cholangiopancreatography, Endoscopic Retrograde (adverse effects, methods)
• Constriction, Pathologic (diagnostic imaging, etiology, surgery)
• Endoscopy (methods)
• Female
• Humans
• Male
• Middle Aged
• Pancreatic Ducts (diagnostic imaging)
• Pancreaticoduodenectomy (adverse effects, methods)
• Pancreaticojejunostomy (adverse effects)
• Punctures
• Treatment Outcome
• Young Adult