Percutaneous pancreatic-duct puncture with rendezvous technique can treat stenotic pancreaticojejunostomy

Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society
Yuji OtaShigeki Koide

Abstract

Stenotic pancreatico-enteric anastomosis is one of the serious late complications after a pancreaticoduodenectomy. We report a case of stenotic pancreaticojejunostomy with a pancreatic juice fistula drained externally, which was treated using percutaneous procedures combined with a rendezvous method. A 77-year-old woman was referred to our hospital for an endoscopic treatment to remove a percutaneous drainage tube from a fluid collection due to pancreatic juice fistula. She had undergone pylorus-preserving pancreatoduodenectomy with Roux-en-Y reconstruction due to duodenal carcinoma of Vater's papilla 1 year before the referral to our hospital. Soon after the operation, she had developed a fluid collection adjacent to the anastomosis due to pancreatic juice fistulas and subsequently had undergone its percutaneous drainage. After admission, we tried to dilate the stenotic anastomosis with an endoscopic procedure from the anastomosed jejunal lumen, using an oblique-viewing endoscope. The endoscope reached a portion of the anastomosis, but did not allow us to visualize the entire anastomosis. We punctured the main pancreatic duct under ultrasonography and fluoroscopy, and advanced the needle into the anastomosed jejunum through th...Continue Reading

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Citations

Mar 22, 2014·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Masataka Kikuyama, Tatsuki Ueda
Nov 11, 2015·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jessica L CioffiMichael G House
Aug 21, 2013·World Journal of Gastrointestinal Endoscopy·Koichiro TsutsumiKazuhide Yamamoto
Nov 1, 2016·Case Reports in Pancreatic Cancer·Numa P PerezCristina R Ferrone
Apr 27, 2021·VideoGIE : an Official Video Journal of the American Society for Gastrointestinal Endoscopy·Viliam MasarykFrank Meyer

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