Successful endoscopic treatment of severe pancreaticojejunostomy strictures by puncturing the anastomotic site with an EUS-guided guidewire

Tatsuhide Nabeshima; Atsushi Kanno; Atsushi Masamune; Hiroki Hayashi; Seiji Hongo; Naoki Yoshida; Eriko Nakano; Shin Miura; Shin Hamada; Kazuhiro Kikuta; Kiyoshi Kume; Morihisa Hirota; Michiaki Unno; Tooru Shimosegawa

doi:10.2169/internalmedicine.9133-17

Successful endoscopic treatment of severe pancreaticojejunostomy strictures by puncturing the anastomotic site with an EUS-guided guidewire

Tatsuhide Nabeshima, Atsushi Kanno, Atsushi Masamune, Hiroki Hayashi, Seiji Hongo, Naoki Yoshida, Eriko Nakano, Shin Miura, Shin Hamada, Kazuhiro Kikuta, Kiyoshi Kume, Morihisa Hirota, Michiaki Unno, Tooru Shimosegawa

Tohoku University

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

Pancreaticojejunostomy stricture (PJS) is a late complication of pancreaticoduodenectomy. The endoscopic treatment of PJS is very challenging due to the difficulty of locating the small anastomotic site and passing the stricture using a guidewire. We herein report two cases of severe PJS. These patients could not be treated using only double-balloon endoscopy or endoscopic ultrasound-guided puncture of the main pancreatic duct because of severe stenosis at the anastomotic site. However, we could treat them by the rendezvous technique using the rigid part of the guidewire to penetrate PJS. This method was useful and safe for treating severe PJS.

Original language	English
Pages (from-to)	357-362
Number of pages	6
Journal	Internal Medicine
Volume	57
Issue number	3
DOIs	https://doi.org/10.2169/internalmedicine.9133-17
Publication status	Published - 2018

Keywords

Endoscopic ultrasound
Late complication
Pancreaticoduodenectomy
Pancreaticojejunostomy stricture
Rendezvous technique

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10.2169/internalmedicine.9133-17

Cite this

Nabeshima, T., Kanno, A., Masamune, A., Hayashi, H., Hongo, S., Yoshida, N., Nakano, E., Miura, S., Hamada, S., Kikuta, K., Kume, K., Hirota, M., Unno, M., & Shimosegawa, T. (2018). Successful endoscopic treatment of severe pancreaticojejunostomy strictures by puncturing the anastomotic site with an EUS-guided guidewire. Internal Medicine, 57(3), 357-362. https://doi.org/10.2169/internalmedicine.9133-17

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title = "Successful endoscopic treatment of severe pancreaticojejunostomy strictures by puncturing the anastomotic site with an EUS-guided guidewire",

abstract = "Pancreaticojejunostomy stricture (PJS) is a late complication of pancreaticoduodenectomy. The endoscopic treatment of PJS is very challenging due to the difficulty of locating the small anastomotic site and passing the stricture using a guidewire. We herein report two cases of severe PJS. These patients could not be treated using only double-balloon endoscopy or endoscopic ultrasound-guided puncture of the main pancreatic duct because of severe stenosis at the anastomotic site. However, we could treat them by the rendezvous technique using the rigid part of the guidewire to penetrate PJS. This method was useful and safe for treating severe PJS.",

keywords = "Endoscopic ultrasound, Late complication, Pancreaticoduodenectomy, Pancreaticojejunostomy stricture, Rendezvous technique",

author = "Tatsuhide Nabeshima and Atsushi Kanno and Atsushi Masamune and Hiroki Hayashi and Seiji Hongo and Naoki Yoshida and Eriko Nakano and Shin Miura and Shin Hamada and Kazuhiro Kikuta and Kiyoshi Kume and Morihisa Hirota and Michiaki Unno and Tooru Shimosegawa",

note = "Publisher Copyright: {\textcopyright} 2018 The Japanese Society of Internal Medicine.",

year = "2018",

doi = "10.2169/internalmedicine.9133-17",

language = "English",

volume = "57",

pages = "357--362",

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Nabeshima, T, Kanno, A, Masamune, A, Hayashi, H, Hongo, S, Yoshida, N, Nakano, E, Miura, S , Hamada, S, Kikuta, K, Kume, K, Hirota, M, Unno, M & Shimosegawa, T 2018, 'Successful endoscopic treatment of severe pancreaticojejunostomy strictures by puncturing the anastomotic site with an EUS-guided guidewire', Internal Medicine, vol. 57, no. 3, pp. 357-362. https://doi.org/10.2169/internalmedicine.9133-17

TY - JOUR

T1 - Successful endoscopic treatment of severe pancreaticojejunostomy strictures by puncturing the anastomotic site with an EUS-guided guidewire

AU - Nabeshima, Tatsuhide

AU - Kanno, Atsushi

AU - Masamune, Atsushi

AU - Hayashi, Hiroki

AU - Hongo, Seiji

AU - Yoshida, Naoki

AU - Nakano, Eriko

AU - Miura, Shin

AU - Hamada, Shin

AU - Kikuta, Kazuhiro

AU - Kume, Kiyoshi

AU - Hirota, Morihisa

AU - Unno, Michiaki

AU - Shimosegawa, Tooru

PY - 2018

Y1 - 2018

N2 - Pancreaticojejunostomy stricture (PJS) is a late complication of pancreaticoduodenectomy. The endoscopic treatment of PJS is very challenging due to the difficulty of locating the small anastomotic site and passing the stricture using a guidewire. We herein report two cases of severe PJS. These patients could not be treated using only double-balloon endoscopy or endoscopic ultrasound-guided puncture of the main pancreatic duct because of severe stenosis at the anastomotic site. However, we could treat them by the rendezvous technique using the rigid part of the guidewire to penetrate PJS. This method was useful and safe for treating severe PJS.

AB - Pancreaticojejunostomy stricture (PJS) is a late complication of pancreaticoduodenectomy. The endoscopic treatment of PJS is very challenging due to the difficulty of locating the small anastomotic site and passing the stricture using a guidewire. We herein report two cases of severe PJS. These patients could not be treated using only double-balloon endoscopy or endoscopic ultrasound-guided puncture of the main pancreatic duct because of severe stenosis at the anastomotic site. However, we could treat them by the rendezvous technique using the rigid part of the guidewire to penetrate PJS. This method was useful and safe for treating severe PJS.

KW - Endoscopic ultrasound

KW - Late complication

KW - Pancreaticoduodenectomy

KW - Pancreaticojejunostomy stricture

KW - Rendezvous technique

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ER -

Successful endoscopic treatment of severe pancreaticojejunostomy strictures by puncturing the anastomotic site with an EUS-guided guidewire

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