Khan Zarak, Hayat Umar, Moraveji Sharareh, Adler Douglas G, Siddiqui Ali A
Department of Internal Medicine, St. Mary Mercy Hospital, Livonia, MI, USA.
Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, MN, USA.
Endosc Ultrasound. 2021 Mar-Apr;10(2):98-102. doi: 10.4103/eus.eus_67_20.
EUS has opened a new frontier in endoscopic techniques for accessing pancreatic ducts in patients with failed ERCP. The major indications of EUS-guided pancreatic duct intervention (EUS-PDI) are main pancreatic duct (MPD) strictures due to chronic pancreatitis or strictures of pancreaticojejunal or pancreaticogastric anastomosis after Whipple resection, which lead to recurrent acute pancreatitis. EUS-guided pancreaticogastro or duodenostomy offers an alternative to surgery when transpapillary drainage fails or is not possible. We provide an expert commentary and a brief overview on this relatively novel technique utilizing EUS-PDI creation in patients with impaired drainage of the MPD who have failed other conventional endoscopic techniques for MPD drainage and either are poor surgical candidates or are reluctant to undergo surgery.
对于内镜逆行胰胆管造影（ERCP）失败的患者，超声内镜（EUS）开启了内镜技术进入胰管的新领域。EUS引导下胰管介入术（EUS-PDI）的主要适应证是慢性胰腺炎导致的主胰管（MPD）狭窄，或Whipple切除术后胰空肠或胰胃吻合口狭窄，这些情况会导致复发性急性胰腺炎。当经乳头引流失败或无法进行时，EUS引导下胰胃或十二指肠造口术为手术提供了一种替代方案。我们针对这项相对新颖的技术提供专家评论和简要概述，该技术用于MPD引流受损且其他传统MPD引流内镜技术失败、手术指征不佳或不愿接受手术的患者，通过EUS-PDI来实现。
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