Brief Report

Percutaneous Pancreatography for Treatment of Complicated Pancreatic Duct Strictures
Dia T. Simmons^a, Todd H. Baron^a, Andrew LeRoy^b, Bret T. Petersen<sup>a

a</sup>Division of Gastroenterology & Hepatology, Department of Medicine, and
^bDivision of Vascular & Interventional Radiology, Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minn., USA

Address of Corresponding Author

Pancreatology 2008;8:194-198 (DOI: 10.1159/000123608)

  Key Words

• Endoscopic retrograde pancreatography
• Interventional radiology
• Pancreatic duct stricture
• Percutaneous therapy

  Abstract

Background: Percutaneous transhepatic cholangiography was developed over 30 years ago for the diagnosis of biliary disorders. It has become an accepted interventional technique for management of biliary tract diseases, especially in patients who have failed attempted endoscopic retrograde pancreatography or have altered anatomy that makes the biliary tree endoscopically inaccessible. The correlative procedure, which we term 'percutaneous pancreatography' (PP), has only been described once in the literature. Case Presentations: We report the outcome of 4 patients undergoing PP for management of difficult pancreatic duct strictures. In all patients, PP was used to provide access and therapy of otherwise endoscopically impassable pancreatic duct strictures. PP-guided pancreatic stent duct placement was performed and allowed for subsequent successful endoscopic management of complex, benign pancreatic duct obstructions. Conclusions: PP is a useful modality for management of otherwise endoscopically impassable pancreatic duct strictures.

Copyright © 2008 S. Karger AG, Basel and IAP

  References

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Cope C, Tuite C, Burke DR, Long WB: Percutaneous management of chronic pancreatic duct strictures and external fistulas with long-term results. J Vasc Interv Radiol 2001;12:104-110.

2.

Chebli JM, Gaburri PD, de Souza AF, Ornellas AT, Martins Junior EV, Chebli LA, Felga GE, Pinto JR: Internal pancreatic fistulas: proposal of a management algorithm based on a case series analysis. J Clin Gastroenterol 2004;38:795-800.

3.

Saftoiu A, Dumitrescu D, Stoica M, Gheonea DI, Ciurea T, Georgescu A, Andrei E: EUS-Assisted rendezvous stenting of the pancreatic duct for chronic calcifying pancreatitis with multiple pseudocysts. Pancreatology 2007;7:74-79.

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Will U, Meyer F, Manger T, Wanzar I: Endoscopic ultrasound-assisted rendezvous maneuver to achieve pancreatic duct drainage in obstructive chronic pancreatitis. Endoscopy 2005;37:171-173.

5.

Mallery S, Matlock J, Freeman ML: EUS-guided rendezvous drainage of obstructed biliary and pancreatic ducts: report of 6 cases. Gastrointest Endosc 2004;59:100-107.

  Author Contacts

Todd H. Baron, MD
200 First Street SW, Charlton 8
Rochester, MN 55905 (USA)
Tel. +1 507 266 6931, Fax +1 507 266 3939
E-Mail baron.todd@mayo.edu

  Article Information

Received: May 31, 2007
Accepted after revision: September 2, 2007
Published online: April 1, 2008
Number of Print Pages : 5
Number of Figures : 2, Number of Tables : 0, Number of References : 5

  Publication Details

Pancreatology

Vol. 8, No. 2, Year 2008 (Cover Date: May 2008)

Journal Editor: Urrutia R. (Rochester, Minn.)
ISSN: 1424-3903 (Print), eISSN: 1424-3911 (Online)

For additional information: http://www.karger.com/PAN

  Drug Dosage / Copyright

Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.