Outcomes of minor versus major papilla rendez-vous for EUS-guided pancreatic duct drainage.
Chronic pancreatitis
EUS-guided pancreatogastrostomy
Endoscopic retrograde pancreatography
Main pancreatic duct stones
Journal
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385
Informations de publication
Date de publication:
07 Aug 2023
07 Aug 2023
Historique:
received:
07
06
2023
revised:
22
07
2023
accepted:
25
07
2023
medline:
10
8
2023
pubmed:
10
8
2023
entrez:
9
8
2023
Statut:
aheadofprint
Résumé
EUS-guided pancreatic duct drainage (EUS-PD) using rendez-vous has been suggested as a safer alternative to pancreatogastrostomy. Fibrostenotic disease in the pancreatic head may however preclude major papilla rendez-vous, leading to preferential guidewire advancement through the minor papilla. Our aim was to compare the outcomes of minor and major papilla rendez-vous. This is a tertiary single-center retrospective analysis of all consecutive EUS-PD procedures performed from 2015 to April 2022. EUS-PD was only performed following failed retrograde attempts. Successful EUS-PD rendez-vous cases were included and minor and major papilla procedures were compared. Thirty-three patients were included in the final analysis (66.6% male, mean age 56.1 [SD±14.8] years, 54.6% active smokers). In 21 patients (63.6%), minor papilla rendez-vous was attained. Clinical success was achieved in 81.0% vs. 58.3% in the major papilla group (p = 0.230). The overall incidence of AE was similar in both groups (9 [42.9%] vs. 4 [33.3%] events, p = 0.719), with a comparable distribution in severe, moderate and mild AE. Incidence of recurrent pancreatitis was almost identical (28.6% vs. 25.0%, p = 1.000). For patients with symptomatic chronic pancreatitis, EUS-PD using minor or major papilla rendez-vous attained similar results, suggesting that pancreatic duct drainage through the minor papilla can be considered as equally effective.
Identifiants
pubmed: 37558573
pii: S1590-8658(23)00779-X
doi: 10.1016/j.dld.2023.07.027
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of interest Michiel Bronswijk and Diederik Persyn declare no competing interests. Schalk van der Merwe holds the Cook chair in Interventional endoscopy and holds consultancy agreements with Cook, Pentax and Olympus. Wim Laleman co-chairs the Boston-Scientific Chair in Therapeutic Biliopancreatic Endoscopy with Schalk Van der Merwe and has consultancy agreements with Boston Scientific and Cook. Hannah van Malenstein holds a consultancy agreement with Boston-Scientific.