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...

Descripción completa

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
_version_ 1783302454118449152
author 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
author_facet 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
author_sort Nabeshima, Tatsuhide
collection PubMed
description 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.
format Online
Article
Text
id pubmed-5827316
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher The Japanese Society of Internal Medicine
record_format MEDLINE/PubMed
spelling pubmed-58273162018-02-28 Successful Endoscopic Treatment of Severe Pancreaticojejunostomy Strictures by Puncturing the Anastomotic Site with an EUS-guided Guidewire 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 Intern Med Case Report 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. The Japanese Society of Internal Medicine 2017-11-20 2018-02-01 /pmc/articles/PMC5827316/ /pubmed/29151507 http://dx.doi.org/10.2169/internalmedicine.9133-17 Text en Copyright © 2018 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
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
Successful Endoscopic Treatment of Severe Pancreaticojejunostomy Strictures by Puncturing the Anastomotic Site with an EUS-guided Guidewire
title Successful Endoscopic Treatment of Severe Pancreaticojejunostomy Strictures by Puncturing the Anastomotic Site with an EUS-guided Guidewire
title_full Successful Endoscopic Treatment of Severe Pancreaticojejunostomy Strictures by Puncturing the Anastomotic Site with an EUS-guided Guidewire
title_fullStr Successful Endoscopic Treatment of Severe Pancreaticojejunostomy Strictures by Puncturing the Anastomotic Site with an EUS-guided Guidewire
title_full_unstemmed Successful Endoscopic Treatment of Severe Pancreaticojejunostomy Strictures by Puncturing the Anastomotic Site with an EUS-guided Guidewire
title_short Successful Endoscopic Treatment of Severe Pancreaticojejunostomy Strictures by Puncturing the Anastomotic Site with an EUS-guided Guidewire
title_sort successful endoscopic treatment of severe pancreaticojejunostomy strictures by puncturing the anastomotic site with an eus-guided guidewire
topic Case Report
url 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
work_keys_str_mv AT nabeshimatatsuhide successfulendoscopictreatmentofseverepancreaticojejunostomystricturesbypuncturingtheanastomoticsitewithaneusguidedguidewire
AT kannoatsushi successfulendoscopictreatmentofseverepancreaticojejunostomystricturesbypuncturingtheanastomoticsitewithaneusguidedguidewire
AT masamuneatsushi successfulendoscopictreatmentofseverepancreaticojejunostomystricturesbypuncturingtheanastomoticsitewithaneusguidedguidewire
AT hayashihiroki successfulendoscopictreatmentofseverepancreaticojejunostomystricturesbypuncturingtheanastomoticsitewithaneusguidedguidewire
AT hongoseiji successfulendoscopictreatmentofseverepancreaticojejunostomystricturesbypuncturingtheanastomoticsitewithaneusguidedguidewire
AT yoshidanaoki successfulendoscopictreatmentofseverepancreaticojejunostomystricturesbypuncturingtheanastomoticsitewithaneusguidedguidewire
AT nakanoeriko successfulendoscopictreatmentofseverepancreaticojejunostomystricturesbypuncturingtheanastomoticsitewithaneusguidedguidewire
AT miurashin successfulendoscopictreatmentofseverepancreaticojejunostomystricturesbypuncturingtheanastomoticsitewithaneusguidedguidewire
AT hamadashin successfulendoscopictreatmentofseverepancreaticojejunostomystricturesbypuncturingtheanastomoticsitewithaneusguidedguidewire
AT kikutakazuhiro successfulendoscopictreatmentofseverepancreaticojejunostomystricturesbypuncturingtheanastomoticsitewithaneusguidedguidewire
AT kumekiyoshi successfulendoscopictreatmentofseverepancreaticojejunostomystricturesbypuncturingtheanastomoticsitewithaneusguidedguidewire
AT hirotamorihisa successfulendoscopictreatmentofseverepancreaticojejunostomystricturesbypuncturingtheanastomoticsitewithaneusguidedguidewire
AT unnomichiaki successfulendoscopictreatmentofseverepancreaticojejunostomystricturesbypuncturingtheanastomoticsitewithaneusguidedguidewire
AT shimosegawatooru successfulendoscopictreatmentofseverepancreaticojejunostomystricturesbypuncturingtheanastomoticsitewithaneusguidedguidewire

Ejemplares similares