Shimamura Yuto, Mosko Jeffrey, Teshima Christopher, May Gary R
Division of Gastroenterology, St. Michael's Hospital, University of Toronto, ON, Canada.
Clin Endosc. 2017 Mar;50(2):112-116. doi: 10.5946/ce.2017.046. Epub 2017 Mar 30.
Endoscopic ultrasound-guided pancreatic duct intervention (EUS-PDI) is an emerging endoscopic approach allowing access and intervention to the pancreatic duct (PD) for patients with failed endoscopic retrograde pancreatography (ERP) or patients with surgically altered anatomy. As opposed to biliary drainage for which percutaneous drainage is an alternative following failed endoscopic retrograde cholangiopancreatography (ERCP), the treatment options after failed ERP are very limited. Therefore, endoscopic ultrasound (EUS)-guided access to the PD and options for subsequent drainage may play an important role as an alternative to surgical intervention. However, this approach is technically demanding with a high risk of complications, and should only be performed by highly experienced endoscopists. In this review, we describe an overview of the current endoscopic approaches, basic technical tips, and outcomes using these procedures.
内镜超声引导下胰管介入治疗（EUS-PDI）是一种新兴的内镜技术，可为内镜逆行胰胆管造影（ERP）失败的患者或解剖结构发生手术改变的患者提供进入胰管（PD）并进行干预的途径。与胆管引流不同，内镜逆行胰胆管造影（ERCP）失败后经皮引流是胆管引流的一种替代方法，而ERP失败后的治疗选择非常有限。因此，内镜超声（EUS）引导下进入PD以及后续引流的选择可能作为手术干预的替代方法发挥重要作用。然而，这种方法技术要求高，并发症风险大，应由经验丰富的内镜医师进行操作。在本综述中，我们概述了当前的内镜治疗方法、基本技术要点以及使用这些方法的治疗结果。
