Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Successful Endoscopic Treatment of Severe Pancreaticojejunostomy Strictures by Puncturing the Anastomotic Site with an EUS-guided Guidewire
Tatsuhide NabeshimaAtsushi KannoAtsushi MasamuneHiroki HayashiSeiji HongoNaoki YoshidaEriko NakanoShin MiuraShin HamadaKazuhiro KikutaKiyoshi KumeMorihisa HirotaMichiaki UnnoTooru Shimosegawa
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JOURNALS OPEN ACCESS

2018 Volume 57 Issue 3 Pages 357-362

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Abstract

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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© 2018 by The Japanese Society of Internal Medicine
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