Successful EUS-guided nondilated pancreatic duct stent placement?in patient with refractory pancreatic fistula after pancreaticoduodenectomy

摘要

Despite recent advances in interventional endoscopicultrasound (EUS), EUS-guided pancreatic drainage (EUSPD) remains extremely technically challenging and thereare few centers with substantial expertise. The normalpancreatic duct is too narrow to cannulate, and transpancreatic puncture carries a highrisk of adverse events. In this case,we used EUS and a newly designed plastic stent (ThroughPass Type IT, Gadelius Medical, Tokyo, Japan) in the pancreatic duct.1 The stent has a total length of 20 cm, an effectivelength of 15 cm, and 4 flanges (2 at the distal end and 2 atthe proximal end). The proximal end has a pigtail structureand the distal end is tapered. This stent remains in placebecause of its shape and the anti-migration flanges.