DEN Open (Apr 2022)

Transjejunal endoscopic ultrasound‐guided pancreatic drainage for pancreatic jejunostomy stricture using a forward‐viewing echoendoscope in a patient with altered anatomy

  • Hiroshi Shimizu,
  • Rei Suzuki,
  • Yuki Sato,
  • Tadayuki Takagi,
  • Naoto Abe,
  • Hiroki Irie,
  • Mitsuru Sugimoto,
  • Takumi Yanagita,
  • Ryoichiro Kobashi,
  • Minami Hashimoto,
  • Tsunetaka Kato,
  • Mika Takasumi,
  • Jun Nakamura,
  • Takuto Hikichi,
  • Hiromasa Ohira

DOI
https://doi.org/10.1002/deo2.114
Journal volume & issue
Vol. 2, no. 1
pp. n/a – n/a

Abstract

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ABSTRACT Pancreatic jejunostomy stricture (PJS) is one of the major late complications after pancreaticoduodenectomy. Endoscopic ultrasound‐guided pancreatic drainage (EUS‐PD) is considered a salvage treatment for symptomatic PJS after endoscopic retrograde pancreatography failure; however, the technical success rate of the endoscopic treatment of PJS remains unsatisfactory, mainly due to surgically altered anatomy. Herein, we describe a case of PJS successfully treated with transjejunal EUS‐PD using a forward‐viewing echoendoscope. A 62‐year‐old man who suffered from repetitive severe back pain due to PJS was referred to our hospital. Since transgastric EUS‐PD was difficult, we attempted transjejunal EUS‐PD using a forward‐viewing echoendoscope. To facilitate scope insertion, we first straightened the afferent jejunal loop and placed a stiff guidewire. With this scheme, we successfully performed transjejunal EUS‐PD and placed a 5‐Fr plastic stent. In conclusion, this technique is useful for treating patients with PJS when transgastric EUS‐PD is difficult.

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