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Pancreato-Biliary Cancer – Clinical Study
Oncology 2017;93(suppl 1):87–88
DOI: 10.1159/000481238
EUS-Guided Pancreatic Duct Drainage
for Repeat Pancreatitis in a Patient with
Pancreatic Cancer
Ken Kamata Mamoru Takenaka Kosuke Minaga Toshiharu Sakurai
Tomohiro Watanabe Naoshi Nishida Masatoshi Kudo
Department of Gastroenterology and Hepatology, Kindai University School of Medicine, Osaka-Sayama, Japan
from the tail side of the stone, with localized pancreatitis
observed around the pancreatic tail (Fig. 1). The pancre-
atic cancer was located in the pancreatic head, whereas
the pancreatic stone was located in the pancreatic body
(Fig. 1). After pancreatitis was resolved, transpapillary
pancreatic duct drainage was attempted, but the guide
wire could not be deployed over the pancreatic duct stric-
ture caused by the tumor. Then, EUS-PD was performed
to prevent pancreatitis induced by a pancreatic duct stric-
ture. The patient was placed under sedation with a bolus
infusion of 0.05 ml/kg propofol. The dilated pancreatic
duct from the tail side of the stone, as viewed echoendo-
scopically (GF-UCT260; Olympus) from the stomach po-
sition, was punctured with a 19-gauge needle (Sonotip;
Medi-Globe), with correct puncturing confirmed with
contrast medium (Fig. 2). A 0.025-inch guidewire (Visi-
Glide2; Olympus) was inserted toward the pancreatic tail.
After dilating the fistulous tract using a diathermic dila-
tor, a 7-Fr plastic stent (7 cm in length; Boston Scientific)
was successfully deployed (Fig. 3). There were no compli-
cations during the procedure. Seven days later, the pa-
tient’s serum amylase concentration had decreased to 88
U/L and he started dietary intake. One month after the
procedure, he resumed chemotherapy, with no recur-
rence of pancreatitis to date. Findings in this patient in-
Keywords
Pancreatic cancer · Endoscopic ultrasonography ·
Pancreatitis
Abstract
Endoscopic ultrasound-guided pancreatic drainage (EUS-
PD) was performed in a patient with unresectable pancre-
atic cancer who developed pancreatitis. In this case, EUS-PD
was useful as salvage therapy for pancreatitis as the trans-
papillary approach was difficult. © 2017 S. Karger AG, Basel
Endoscopic ultrasound-guided pancreatic drainage
(EUS-PD) has been described as a new drainage
technique after unsuccessful transpapillary approach for
pancreatic duct strictures [1–3]. Our patient was a
74-year-old man with unresectable pancreatic cancer re-
ceiving chemotherapy. Due to repeated pancreatitis,
however, he could not continue treatment and was forced
to stop chemotherapy. The patient had no history of
chronic pancreatitis but abdominal CT showed a pancre-
atic duct stone in the main pancreatic duct at the pancre-
atic body. The main pancreatic duct was slightly dilated
Published online: December 20, 2017
Dr. Mamoru Takenaka
Department of Gastroenterology and Hepatology
Kindai University Faculty of Medicine
377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511 (Japan)
E-Mail mamoxyo45 @ gmail.com
© 2017 S. Karger AG, Basel
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