Efficacy and Safety of Peroral Pancreatoscopy Through the Fistula Created by Endoscopic Ultrasound–Guided Pancreaticogastrostomy. Issue 3 (March 2022)

• Record Type: Journal Article
• Authors: Suzuki, Akinori; Ishii, Shigeto; Fujisawa, Toshio; Saito, Hiroaki; Takasaki, Yusuke; Takahashi, Sho; Yamagata, Wataru; Ochiai, Kazushige; Tomishima, Ko; Isayama, Hiroyuki
• Is Part Of: Pancreas. Volume 51:Issue 3(2022)
• Page Start: 228
• Page End: 233
• Publication Date: 2022-03
• Subjects: endoscopic ultrasound -- interventional EUS -- EUS-guided pancreaticogastrostomy -- pancreatoscopy; Pancreas -- Diseases -- Periodicals; Pancreas -- Periodicals; Neuroendocrine tumors -- Periodicals; 616.37005
• DOI: 10.1097/MPA.0000000000002003
• Languages: English
• ISSNs: 0885-3177

Abstract

Abstract : Objectives: Endoscopic ultrasound/endosonography-guided pancreaticogastrostomy (EUS-PGS) is a useful alternative when endoscopic retrograde pancreatography is difficult. Recently, many procedures, including peroral pancreatoscopy (POPS), have been performed through the mature fistula (MF) created by EUS-PGS. We evaluate the efficacy and safety of POPS to diagnose and treat pancreatic ductal stricture/pancreato-jejunal anastomotic stricture (PDS/PJAS) through the MF. Methods: Twenty patients underwent EUS-PGS; 13 of these underwent POPS through the MF at Juntendo University Hospital. All patients were studied retrospectively in terms of technical and clinical success rates and adverse events (AEs). Results: The technical and clinical success rates of EUS-PGS were 95% and 100%. The early and late AEs rates were 20% and 15%. The technical success rate of POPS was 100%, with one AE. Biopsy of PDS/PJAS under POPS guidance revealed recurrent/residual intrapapillary mucinous adenoma (3 patients) and benign fibrotic stricture (10 patients). In the latter patients, multiple plastic stents were placed to dilate PDS/PJAS. Four patients with improvement of PDS/PJAS were stent free, but the remaining patients were not yet. Conclusions: Endoscopic ultrasound/endosonography-guided pancreaticogastrostomy and various procedures (including POPS) performed through the MF are feasible and effective and can diagnose and treat PDS/PJAS with acceptable AEs rates.