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》

タイトル 内IS8-7:

Technical and clinical outcomes of EUS-guided pancreatic drainage in patients with failed ERCP.

演者 N. Ikeuchi(The Department of Gastroenterology and Hepatology, Tokyo Medical University)
共同演者 T. Kurihara(The Department of Gastroenterology and Hepatology, Tokyo Medical University), T. Itoi(The Department of Gastroenterology and Hepatology, Tokyo Medical University)
抄録 Background: EUS-guided pancreatic drainage has been advocated as a rescue treatment for management of patients in whom ERCP is technically unsuccessful. The aim of this study is to evaluate the feasibility and efficacy of EUS-guided drainage.Patients: This study involved 17 consecutive patients with relapse symptomatic pancreatitis or epigastric pain for failed ERP. Results: A total of 21 EUS-guided PD drainage procedures were performed in 17 patients (age: mean 60.1). Stent placement using the EUS-guided rendezvous technique was attempted in all cases. The rendezvous technique was successful in 14 of 21 procedures (66.7%). 5 of 7 procedures with an unsuccessful rendezvous technique successfully underwent EUS-PD stenting. In the 2 remaining procedures (9.5%), puncture and pancreatography were successful; however, antegrade passage of the guidewire failed. Complications (5.6%) related to EUS-guided PD puncture included a pancreatic pseudocyst with an aneurysm in the splenic artery. Symptom and recurrent pancreatitis improved in all patients who successfully underwent EUS-PD drainage. Conclusion: The EUS-guided decompression of PD is a feasible and effective treatment for the management of symptomatic high pressure PD due to stricture of the PD and/or stenotic pancreatodigestive anastomosis.
索引用語 Interventional EUS, Pancreatic drainage