Abstract | BACKGROUND: EUS-guided pancreaticogastrostomy (EPG) has been reported as an alternative to surgery in cases of pancreatic stricture where ERCP is unsuccessful. OBJECTIVE: We analyzed our 3-year experience with this innovative technique. DESIGN: Patients with failed ERCP for pancreatic drainage were offered EPG over a 3-year period and were followed up prospectively in terms of clinical and radiologic response. SETTING: Tertiary care center offering ERCP and interventional EUS. PATIENTS: INTERVENTION: MAIN OUTCOME MEASUREMENTS: Mean main pancreatic duct size, pain score, and weight before and after intervention. RESULTS: Ten patients had successful endoprosthesis placement across the pancreaticogastric fistula. One patient underwent brush cytologic study, which diagnosed pancreatic malignancy, and underwent surgical resection. After a mean follow-up of 14 months, the mean pancreatic duct size in treated patients decreased from 4.6 to 3.0 mm (P = .01); the pain score decreased from 7.3 to 3.6 (P = .01). Complications included one case of bleeding requiring hemoclip placement and 1 case of contained perforation. LIMITATIONS: Pilot study from a single center. CONCLUSIONS: EPG is a safe and feasible alternative to surgical intervention in this subgroup of patients where conventional ERCP is not possible.
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Authors | Michel Kahaleh, Alfredo J Hernandez, Jeffrey Tokar, Reid B Adams, Vanessa M Shami, Paul Yeaton |
Journal | Gastrointestinal endoscopy
(Gastrointest Endosc)
Vol. 65
Issue 2
Pg. 224-30
(Feb 2007)
ISSN: 0016-5107 [Print] United States |
PMID | 17141775
(Publication Type: Journal Article)
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Topics |
- Adult
- Aged
- Cholangiopancreatography, Endoscopic Retrograde
- Constriction, Pathologic
- Drainage
(methods)
- Endoscopy, Gastrointestinal
- Endosonography
- Feasibility Studies
- Female
- Humans
- Male
- Middle Aged
- Pancreatic Diseases
(therapy)
- Pilot Projects
- Prosthesis Implantation
(methods)
- Stents
- Treatment Outcome
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