Endoscopic Ultrasound

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 10  |  Issue : 1  |  Page : 33--38

EUS-guided transanastomotic drainage for severe biliopancreatic anastomotic stricture using a forward-viewing echoendoscope in patients with surgically altered anatomy


Tomohisa Iwai1, Mitsuhiro Kida1, Hiroshi Yamauchi1, Kosuke Okuwaki1, Toru Kaneko1, Rikiya Hasegawa1, Masafumi Watanabe1, Takahiro Kurosu1, Hiroshi Imaizumi2, Wasaburo Koizumi1 
1 Department of Gastroenterology, Kitasato University Hospital, Sagamihara, Kanagawa, Japan
2 Department of Gastroenterology, JCHO Sagamino Hospital, Sagamihara, Kanagawa, Japan

Correspondence Address:
Dr. Tomohisa Iwai
Department of Gastroenterology, Kitasato University Hospital, 1-15-1 Kitasato, Minami, Sagamihara, 252-0374, Kanagawa
Japan

Background and Objectives: Balloon enteroscopy-assisted ERCP (BE-ERCP) has become the first-line therapy for biliopancreatic anastomotic strictures. However, it is not always successful, and salvage methods have not been established. This study aimed to evaluate the outcomes of EUS-guided transanastomotic drainage using a forward-viewing (FV) echoendoscope. Patients and Methods: Of eight cases wherein BE-ERCP treatment failed due to severe or complete benign anastomotic stricture, seven cases underwent EUS-guided choledochojejunostomy, and EUS-guided pancreaticojejunostomy was applied in one case after intubating an FV echoendoscope into the anastomotic site. Results: The success rate of reaching the target site was 100% (8/8) for patients after modified Child resection. The median time to reach the anastomosis was 5 min (range: 3–17 min), and the technical success rate for drainage was 75% (6/8). The median total procedure time was 33.5 min (range: 22–45 min) for six successful cases. Cautery dilatation catheters were necessary to dilate the puncture site in all cases, and no early complications were observed. During the follow-up period (median: 13.3 months [range: 6.5–60.3]), recurrence of the stricture occurred in one case, and a stent-free status was achieved after 6–12 months of stent placement in five cases. Conclusions: EUS-guided transanastomotic drainage using an FV echoendoscope is a feasible and safe rescue technique for the management of benign severe biliopancreatic anastomotic strictures.


How to cite this article:
Iwai T, Kida M, Yamauchi H, Okuwaki K, Kaneko T, Hasegawa R, Watanabe M, Kurosu T, Imaizumi H, Koizumi W. EUS-guided transanastomotic drainage for severe biliopancreatic anastomotic stricture using a forward-viewing echoendoscope in patients with surgically altered anatomy.Endosc Ultrasound 2021;10:33-38


How to cite this URL:
Iwai T, Kida M, Yamauchi H, Okuwaki K, Kaneko T, Hasegawa R, Watanabe M, Kurosu T, Imaizumi H, Koizumi W. EUS-guided transanastomotic drainage for severe biliopancreatic anastomotic stricture using a forward-viewing echoendoscope in patients with surgically altered anatomy. Endosc Ultrasound [serial online] 2021 [cited 2021 Apr 12 ];10:33-38
Available from: http://www.eusjournal.com/article.asp?issn=2303-9027;year=2021;volume=10;issue=1;spage=33;epage=38;aulast=Iwai;type=0