Progress of Digestive Endoscopy
Online ISSN : 2187-4999
Print ISSN : 1348-9844
ISSN-L : 1348-9844
Case Report
A Case of Symptomatic Pancreatic Duct Stricture Effectively Treated with Pancreatic Duct Drainage using the EUS-RV
Ritsu Onodera, Kosuke Okuwaki, Mitsuhiro Kida, Tomohisa Iwai, Masafumi Watanabe, Takahiro Kurosu, Rikiya Hasegawa, Toru Kaneko, Hiroshi Yamauchi, Hiroshi Imaizumi, Wasaburo Koizumi
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2020 Volume 96 Issue 1 Pages 198-200

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Abstract

A 60-year-old male developed symptomatic pancreatic duct stricture due to pancreatic metastasis from lung cancer. Transpapillary pancreatic duct drainage was challenging; hence, pancreatic duct drainage was successfully performed using the endoscopic ultrasonography-guided rendezvous procedure (EUS-RV). The guidewire was navigated to the duodenum, beyond the stricture site in the main pancreatic duct. The procedure was successful as the guidewire was maintained in a U-shape by securing the distance between the puncture and pancreatic stricture sites. By replacing the catheter with a tapered one, guidewire seeking was simplified. However, the EUS-RV technique requires advanced skills. It is important to note that completing the procedure often requires more than one session. The formation of a pancreatic duct-gastrointestinal fistula should be prioritized; transpapillary stent placement can be performed through RV route later.

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© 2020 Japan Gastroenterological Endoscopy Society Kanto Chapter
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