Clinical Endoscopy

  • 제58권2호
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  • Pages.311-319
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  • 2025
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
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Safety and efficacy of trans-afferent loop endoscopic ultrasound-guided pancreaticojejunostomy for post pancreaticoduodenectomy anastomotic stricture using the forward-viewing echoendoscope: a retrospective study from Japan

  • Ahmed Sadek (Department of Internal Medicine, Faculty of Medicine, Helwan University) ;
  • Kazuo Hara (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Nozomi Okuno (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Shin Haba (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Takamichi Kuwahara (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Toshitaka Fukui (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Minako Urata (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Takashi Kondo (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Yoshitaro Yamamoto (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Kenneth Tachi (Department of Gastroenterology, Aichi Cancer Center Hospital)
  • 투고 : 2024.04.12
  • 심사 : 2024.05.31
  • 발행 : 2025.03.30
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초록

Background/Aims: Endoscopic ultrasound (EUS)-guided pancreatic duct drainage is a well-established procedure for managing pancreaticojejunal anastomotic strictures (PJAS) post-Whipple surgery. In this study, we examined the effectiveness and safety of EUS-guided pancreaticojejunostomy (EUS-PJS). Methods: This retrospective, single-arm study was performed at Aichi Cancer Center Hospital on 10 patients who underwent EUS-guided pancreaticojejunostomy through the afferent jejunal loop using a forward-viewing echoendoscope when endoscopic retrograde pancreatography failed. Our primary endpoint was technical success rate, defined as successful stent insertion. The secondary endpoints were early and late adverse events. Results: A total of 10 patients underwent EUS-PJS between February 2019 and October 2023. The technical success rate was 100%. The median procedure time was 23.5 minutes. No remarkable early or late adverse events related to the procedure, except for fever, occurred in two patients. The median follow-up duration was 9.5 months, and the median number of stent exchanges was two. A stentfree state was achieved in three patients. Conclusions: EUS-PJS for PJAS management after pancreaticoduodenectomy appears to be an effective and safe procedure with the potential advantages of fewer reinterventions and the creation of a permanent drainage fistula.

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참고문헌

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