Successful Endoscopic Treatment of Severe Pancreaticojejunostomy Strictures by Puncturing the Anastomotic Site with an EUS-guided Guidewire

Pancreaticojejunostomy stricture (PJS) is a late complication of pancreaticoduodenectomy. The endoscopic treatment of PJS is very challenging due to the difficulty of locating the small anastomotic site and passing the stricture using a guidewire. We herein report two cases of severe PJS. These pati...

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Detalles Bibliográficos
Autores principales: Nabeshima, Tatsuhide, Kanno, Atsushi, Masamune, Atsushi, Hayashi, Hiroki, Hongo, Seiji, Yoshida, Naoki, Nakano, Eriko, Miura, Shin, Hamada, Shin, Kikuta, Kazuhiro, Kume, Kiyoshi, Hirota, Morihisa, Unno, Michiaki, Shimosegawa, Tooru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2017
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5827316/
https://www.ncbi.nlm.nih.gov/pubmed/29151507
http://dx.doi.org/10.2169/internalmedicine.9133-17
Descripción
Sumario:Pancreaticojejunostomy stricture (PJS) is a late complication of pancreaticoduodenectomy. The endoscopic treatment of PJS is very challenging due to the difficulty of locating the small anastomotic site and passing the stricture using a guidewire. We herein report two cases of severe PJS. These patients could not be treated using only double-balloon endoscopy or endoscopic ultrasound-guided puncture of the main pancreatic duct because of severe stenosis at the anastomotic site. However, we could treat them by the rendezvous technique using the rigid part of the guidewire to penetrate PJS. This method was useful and safe for treating severe PJS.

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