PMID- 32376334
OWN - NLM
STAT- MEDLINE
DCOM- 20210427
LR  - 20210427
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 92
IP  - 5
DP  - 2020 Nov
TI  - Endoscopic endgame for obstructive pancreatopathy: outcomes of anterograde 
      EUS-guided pancreatic duct drainage. A dual-center study.
PG  - 1055-1066
LID - S0016-5107(20)34261-9 [pii]
LID - 10.1016/j.gie.2020.04.061 [doi]
AB  - BACKGROUND AND AIMS: Anterograde endoscopic ultrasound-guided pancreatic duct 
      drainage (EUS-PDD) refers to transmural drainage of the main pancreatic duct via 
      an endoprosthesis passed anterograde through the gastric (or intestinal) wall. 
      Anterograde EUS-PDD is a rescue procedure for recalcitrant cases of benign 
      obstructive pancreatopathy. METHODS: We conducted a dual-center retrospective 
      chart review of 28 patients (mean age, 59 years; 50% female) who underwent 
      attempted anterograde EUS-PDD between April 2016 and September 2019 for chronic 
      pancreatitis (CP) (93%) or pancreaticojejunostomy stenosis (PJS) after Whipple 
      resection (7%). The study endpoint was achievement of 
      transpapillary/transanastomotic drainage (definitive therapy). RESULTS: 
      Gastropancreaticoenterostomy (ring drainage, definitive therapy) was successfully 
      performed during the index procedure in the 2 patients with PJS (technical 
      success, 100%). Clinical success was 100% in the 2 ring drainage recipients 
      during a mean 18-month follow-up period. The remaining 26 patients with CP 
      underwent attempted pancreaticogastrostomy (PG) with 81% technical success, 75% 
      clinical success, and 15% adverse events (AEs). Repeat endoscopic transmural 
      interventions were performed in the 15 patients with clinical success after PG 
      creation. Definitive therapy transpired in all 15 patients after a median 1 
      repeat procedure per patient. Clinical success after definitive therapy was 
      maintained in all 15 patients (100%) during a median 4.5-month follow-up. 
      CONCLUSIONS: In agreement with previous studies, our study showed mild to 
      moderately high rates of technical failure (19%), clinical failure (25%), and AEs 
      (15%) during index drainage (PG creation). Among patients with CP with both 
      technical and clinical success after index PG creation (n = 15), 100% definitive 
      therapy was achieved and clinical outcomes were excellent (100% clinical success, 
      0% AEs).
CI  - Copyright (c) 2020 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Krafft, Matthew R
AU  - Krafft MR
AD  - Section of Gastroenterology and Hepatology, West Virginia University Medicine, 
      Morgantown, West Virginia, USA.
FAU - Croglio, Michael P
AU  - Croglio MP
AD  - Division of Gastroenterology and Hepatology, University of North Carolina Medical 
      Center, Chapel Hill, North Carolina, USA.
FAU - James, Theodore W
AU  - James TW
AD  - Division of Gastroenterology and Hepatology, University of North Carolina Medical 
      Center, Chapel Hill, North Carolina, USA.
FAU - Baron, Todd H
AU  - Baron TH
AD  - Division of Gastroenterology and Hepatology, University of North Carolina Medical 
      Center, Chapel Hill, North Carolina, USA.
FAU - Nasr, John Y
AU  - Nasr JY
AD  - Section of Gastroenterology and Hepatology, West Virginia University Medicine, 
      Morgantown, West Virginia, USA.
LA  - eng
PT  - Journal Article
DEP - 20200504
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
CIN - Gastrointest Endosc. 2020 Nov;92(5):1067-1069. PMID: 33160488
MH  - *Drainage
MH  - *Endosonography
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pancreatic Ducts/diagnostic imaging/surgery
MH  - Retrospective Studies
MH  - Stents
MH  - Treatment Outcome
EDAT- 2020/05/08 06:00
MHDA- 2021/04/28 06:00
CRDT- 2020/05/08 06:00
PHST- 2019/11/05 00:00 [received]
PHST- 2020/04/15 00:00 [accepted]
PHST- 2020/05/08 06:00 [pubmed]
PHST- 2021/04/28 06:00 [medline]
PHST- 2020/05/08 06:00 [entrez]
AID - S0016-5107(20)34261-9 [pii]
AID - 10.1016/j.gie.2020.04.061 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2020 Nov;92(5):1055-1066. doi: 10.1016/j.gie.2020.04.061. 
      Epub 2020 May 4.