{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T22:26:47Z","timestamp":1771540007974,"version":"3.50.1"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Gastroenterol"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>As an alternative instead of a repeat surgical intervention, results (feasibility, safety, and technical and clinical success rate) of EUS-guided pancreatic duct drainage (EUS-PD) in a consecutive patient cohort because of symptomatic postoperative anastomotic stenosis as part of a unicenter observational study in daily clinical practice are presented.<\/jats:p><jats:p>EUS-guided puncture (19-G needle) of the pancreatic duct, pancreaticography, and advancement of a guide wire (0.035 inches) via the anastomosis into the small intestine after previous dilatation of the transgastric access site (using ring knife): 1. if possible, balloon dilatation of the anastomosis and placement of a prosthesis as a gastro-pancreaticojejunostomy (\u201cring drainage\u201d, \u201cgastro-pancreaticojejunostomy\u201d); 2. if not possible (frustrating advancement of the guide wire), again, dilatation of the transgastric access site (using ring knife) and balloon dilatation with a following transgastric placement of a prosthesis (pancreaticogastrostomy).<\/jats:p><jats:p>Out of the complete consecutive patient series with EUS-PD (n=119 cases) from 2004 to 2015, 34 patients (28.5%) were found with a medical history significant for previous surgical intervention at the pancreas who were approached using EUS-PD: in detail, pancreatic head resection in 1.) chronic pancreatitis (n=21; 61.8%) and 2.) malignant tumor lesions (n=13; 38.2%), resp. Pancreaticography was achieved in all subjects (n=34\/34; rate, 100%). In 9\/34 cases, a sufficient flow of contrast media via the anastomotic segment was detected; therefore, drainage was not placed. In the remaining 25 cases, the primary technical success (successful placement of drainage) rate was 64% (n=16\/25 cases). In 9\/25 patients, only dilatation using the passage of a ring knife over the guide wire and a balloon was performed. In detail, stent insertion was either not necessary because of good contrast flow via anastomosis (n=4) or not successful because of dislocation of the guide wire (n=5). However, these nine subjects underwent reintervention: in five patients, ring drainage (n=3) and transgastric drainage (n=2) were achieved, resulting in the definitive technical (drainage placement) success rate of 84% (n=21\/25). In further detail, the two different techniques of drainage insertion such as pancreaticogastrostomy and gastro-pancreaticojejunostomy (ring drainage) were used in 11 patients (plastic stent, n=8; metal stent, n=3 [biliary wallstent, n=2; LAMS, n=1]) and ten subjects, resp.<\/jats:p><jats:p>Finally, long-term clinical success was 92% (n=23\/25).<\/jats:p><jats:p>Overall, there were complications in 6\/34 individuals (rate, 17.6%): bleeding, pressing ulcer by the stent, abscess within the lower sac, postinterventional pseudocyst (n=1 each), and paraluminal collection of contrast medium (n=2).<\/jats:p><jats:p>Alternative EUS-PD is feasible and safe and can avoid surgical intervention; this can result in a distinct improvement in the quality of life, including an acceptable interventional risk. Because of the high technical demands, EUS-PD should only be performed in centers of interventional EUS, with great expertise in this field. Further clinical long-term observation, greater patient cohorts, evaluation of procedural knowledge and data, and further technical advances are required.<\/jats:p>","DOI":"10.1055\/a-2435-4888","type":"journal-article","created":{"date-parts":[[2024,12,7]],"date-time":"2024-12-07T00:00:31Z","timestamp":1733529631000},"page":"2039-2048","source":"Crossref","is-referenced-by-count":3,"title":["Endoscopic ultrasonography-guided drainage of the pancreatic duct (EUS-PD) in postoperative anastomotic stenosis after previous pancreatic resection"],"prefix":"10.1055","volume":"62","author":[{"given":"Uwe","family":"Will","sequence":"additional","affiliation":[{"name":"Dept. of Gastroenterology, Hepatology, Diabetology and General Internal Medicine, Municipal Hospital (\u201cSRH Wald-Klinikum\u201d), Gera, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"F\u00fcldner","sequence":"additional","affiliation":[{"name":"Dept. of Gastroenterology, Hepatology, Diabetology and General Internal Medicine, Municipal Hospital (\u201cSRH Wald-Klinikum\u201d), Gera, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Buechner","sequence":"additional","affiliation":[{"name":"Municipal Hospital (\u201cSRH Wald-Klinikum Gera\u201d); Dept. of Gastroenterology, Hepatology, Diabetology and General Internal Medicine, Gera, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Meyer","sequence":"additional","affiliation":[{"name":"Dept. of General, Abdominal, Vascular and Transplant Surgery, Otto-von-Guericke University with University Hospital, Magdeburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,12,6]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.bpg.2010.03.007","article-title":"Pain management in chronic pancreatitis: A treatment 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