EUS-guided transanastomotic drainage for severe biliopancreatic anastomotic stricture using a forward-viewing echoendoscope in patients with surgically altered anatomy.
EUS-guided transanastomotic drainage
anastomotic stricture
benign stricture
surgically altered anatomy
Journal
Endoscopic ultrasound
ISSN: 2303-9027
Titre abrégé: Endosc Ultrasound
Pays: China
ID NLM: 101622292
Informations de publication
Date de publication:
Historique:
pubmed:
22
1
2021
medline:
22
1
2021
entrez:
21
1
2021
Statut:
ppublish
Résumé
Balloon enteroscopy-assisted ERCP (BE-ERCP) has become the first-line therapy for biliopancreatic anastomotic strictures. However, it is not always successful, and salvage methods have not been established. This study aimed to evaluate the outcomes of EUS-guided transanastomotic drainage using a forward-viewing (FV) echoendoscope. Of eight cases wherein BE-ERCP treatment failed due to severe or complete benign anastomotic stricture, seven cases underwent EUS-guided choledochojejunostomy, and EUS-guided pancreaticojejunostomy was applied in one case after intubating an FV echoendoscope into the anastomotic site. The success rate of reaching the target site was 100% (8/8) for patients after modified Child resection. The median time to reach the anastomosis was 5 min (range: 3-17 min), and the technical success rate for drainage was 75% (6/8). The median total procedure time was 33.5 min (range: 22-45 min) for six successful cases. Cautery dilatation catheters were necessary to dilate the puncture site in all cases, and no early complications were observed. During the follow-up period (median: 13.3 months [range: 6.5-60.3]), recurrence of the stricture occurred in one case, and a stent-free status was achieved after 6-12 months of stent placement in five cases. EUS-guided transanastomotic drainage using an FV echoendoscope is a feasible and safe rescue technique for the management of benign severe biliopancreatic anastomotic strictures.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
Balloon enteroscopy-assisted ERCP (BE-ERCP) has become the first-line therapy for biliopancreatic anastomotic strictures. However, it is not always successful, and salvage methods have not been established. This study aimed to evaluate the outcomes of EUS-guided transanastomotic drainage using a forward-viewing (FV) echoendoscope.
PATIENTS AND METHODS
METHODS
Of eight cases wherein BE-ERCP treatment failed due to severe or complete benign anastomotic stricture, seven cases underwent EUS-guided choledochojejunostomy, and EUS-guided pancreaticojejunostomy was applied in one case after intubating an FV echoendoscope into the anastomotic site.
RESULTS
RESULTS
The success rate of reaching the target site was 100% (8/8) for patients after modified Child resection. The median time to reach the anastomosis was 5 min (range: 3-17 min), and the technical success rate for drainage was 75% (6/8). The median total procedure time was 33.5 min (range: 22-45 min) for six successful cases. Cautery dilatation catheters were necessary to dilate the puncture site in all cases, and no early complications were observed. During the follow-up period (median: 13.3 months [range: 6.5-60.3]), recurrence of the stricture occurred in one case, and a stent-free status was achieved after 6-12 months of stent placement in five cases.
CONCLUSIONS
CONCLUSIONS
EUS-guided transanastomotic drainage using an FV echoendoscope is a feasible and safe rescue technique for the management of benign severe biliopancreatic anastomotic strictures.
Identifiants
pubmed: 33473043
pii: 307448
doi: 10.4103/eus.eus_72_20
pmc: PMC7980695
doi:
Types de publication
Journal Article
Langues
eng
Pagination
33-38Déclaration de conflit d'intérêts
None
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