EUS Pancreatogastrostomy
Advanced Therapeutic ProcedureIndication
Chronic Pancreatitis with pancreatic duct obstruction
Procedure Details
EUS Pancreatogastrostomy was successfully performed. The pancreatic duct was identified and punctured under EUS guidance. A wire was placed into the PD, and the tract was dilated with a 6Fr cystotome. A 10mm x 60mm fully covered metallic SEMS was placed.
A plastic stent was placed inside the metallic stent to stabilize and prevent migration of the metallic stent.
Procedure Steps
- Pancreatic duct identified under EUS guidance
- PD punctured and wire placed into pancreatic duct
- Tract dilated with 6Fr cystotome
- 10mm x 60mm fully covered metallic SEMS placed
- Plastic stent inserted inside metallic stent for stabilization
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ERCP - Pancreatic Duct Stenting
Pancreatic Duct InterventionIndication
Chronic Pancreatitis
Procedure Details
A pinpoint major papilla was noted. PD cannulation was achieved from the minor papilla and dye was injected. The PD was found to be dilated in body and tail up to 5.6mm.
Communication of duct of Santorini was found to be of very small caliber. Cannula was passed into the pancreatic duct of body and tail. Duct of Santorini was dilated up to 4mm with biliary hurricane balloon. A 7Fr x 7cm single pigtail pancreatic stent was placed in the PD.
Key Findings & Steps
- Pinpoint major papilla identified
- PD cannulation achieved via minor papilla
- PD dilated in body and tail (up to 5.6mm)
- Duct of Santorini - small caliber communication noted
- Santorini duct dilated to 4mm with biliary hurricane balloon
- 7Fr x 7cm single pigtail pancreatic stent placed
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