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EUS-guided pancreatic ductal intervention: A comprehensive literature review


1 Department of Internal Medicine, St. Mary Mercy Hospital, Livonia, MI, USA
2 Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, MN, USA
3 Division of Gastroenterology, Hepatology and Nutrition, Stanford University, Palo Alto, CA, USA
4 Division of Gastroenterology, Hepatology and Nutrition, University of Utah, Salt Lake City, UT, USA
5 Division of Gastroenterology and Hepatology, Loma Linda University Health, Loma Linda, CA, USA

Correspondence Address:
Ali A Siddiqui,
Division of Gastroenterology and Hepatology, Loma Linda University Health, 11370 Anderson Street, Suite 3625, Loma Linda, CA 92354
USA
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/eus.eus_67_20

EUS has opened a new frontier in endoscopic techniques for accessing pancreatic ducts in patients with failed ERCP. The major indications of EUS-guided pancreatic duct intervention (EUS-PDI) are main pancreatic duct (MPD) strictures due to chronic pancreatitis or strictures of pancreaticojejunal or pancreaticogastric anastomosis after Whipple resection, which lead to recurrent acute pancreatitis. EUS-guided pancreaticogastro or duodenostomy offers an alternative to surgery when transpapillary drainage fails or is not possible. We provide an expert commentary and a brief overview on this relatively novel technique utilizing EUS-PDI creation in patients with impaired drainage of the MPD who have failed other conventional endoscopic techniques for MPD drainage and either are poor surgical candidates or are reluctant to undergo surgery.


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    -  Khan Z
    -  Hayat U
    -  Moraveji S
    -  Adler DG
    -  Siddiqui AA
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