| セッション情報 |
International Session8(消化器内視鏡学会・消化器病学会合同)
Recent advances in Interventional EUS 《Video》
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| タイトル |
内IS8-5：Traversibility to the papilla decides the feasibility of EUS-guided cholangio-pancreatic access for patients with difficult biliary cannulation
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| 演者 |
K. Kubota（Department of Gastroenterology, Yokohama City University, Graduate School of Medicine） |
| 共同演者 |
K. Hosono（Department of Gastroenterology, Yokohama City University, Graduate School of Medicine）, A. Nakajima（Department of Gastroenterology, Yokohama City University, Graduate School of Medicine） |
| 抄録 |
Background: EUS-guided direct cholangio-pancreatic access (EUS-DCP) may be useful in cases with an inaccessible papilla, however, it is challenging due to the technical difficulty and high complication rate. EUS-rendezvous for antegrade cholangio-pancreatography (EUS-RV) also is feasible in these patients. Aims: To evaluate the indications, feasibility and safety of the EUS-DCP/RV in our case series, then, we present DVD in our procedure.Methods: The success and complication rates were analyzed and compared between patients undergoing EUS-DCP and those undergoing EUS-RV. EUS-guided biliary and/or pancreatic puncture was performed with a 19-gauge needle. Results: Sixteen patients underwent EUS-DCP, including EUS-HGS in four and EUS-CDS in twelve patients. Six patients underwent EUS-RV, including two patients who required double metallic stent deployment for malignant biliary and duodenal obstruction, one with ampullary cancer, two with chronic pancreatisis and one with papillary stricture due to the ampullectomy. The success rate was 62.5% (10/16) in the EUS-DCP group and 100% (6/6) in the EUS-RV group. The complication rate was 25% (4/16) in the EUS-DCP group and 0% in the EUS-RV group, respectively.Conclusions: Although the feasibility of EUS-DCP or EUS-RV depends on the traversibility to the papilla, EUS-RV, rather than EUS-DCP, appears to be more feasible and safe, and may represent the modality of first choice for patients with an inaccessible papilla. |
| 索引用語 |
EUS-guided, difficult cannulation |
