EUS-Guided Transenteric Pancreatic Duct Drainage

  • M. GiovanniniEmail author


Endoscopic drainage requires transpapillary access to the pancreatic duct during ERCP. When ERCP failed, EUS-guided pancreaticogastro- or bulbostomy and/or rendezvous technique offers an alternative to surgery. Although data has demonstrated that the procedure can be safe and effective, EUS-guided PD drainage remains one of the most technically challenging therapeutic EUS interventions, as evidenced by the multiple considerations on device selection and the risk of severe complications.


EUS-guided pancreatic duct drainage Rendezvous technique Failed ERCP 


  1. 1.
    François E, Kahaleh M, Giovannini M, Matos C, Devière J. EUS-guided pancreaticogastrostomy. Gastrointest Endosc. 2002;56(1):128–33.CrossRefGoogle Scholar
  2. 2.
    Barkay O, Sheman S, McHenry L, Yoo BM, Fogel EL, Watkins JL, DeWitt J, Al-Haddad MA, Lehman GA. Therapeutic EUS-assisted endoscopic retrograde pancreatography after failed pancreatic duct cannulation at ERCP. Gastrointest Endosc. 2010;7:1166–73.CrossRefGoogle Scholar
  3. 3.
    Fujii LL, Topazian MD, Abu Dayyeh BK, Baron TH, Chari ST, Farnell MB, Gleeson FC, Gostout CJ, Kendrick ML, Pearson RK, Petersen BT, Truty MJ, Vege SS, Levy MJ. EUS-guided pancreatic duct intervention: outcomes of a single tertiary-care referral center experience. Gastrointest Endosc. 2013;78(6):854–64.CrossRefGoogle Scholar
  4. 4.
    Tessier G, Bories E, Arvanitakis M, Hittelet A, Pesenti C, Le Moine O, Giovannini M, Devière J. US-guided pancreatogastrostomy and pancreatobulbostomy for the treatment of pain in patients with pancreatic ductal dilatation inaccessible for transpapillary endoscopic therapy. Gastrointest Endosc. 2007;65(2):233–41.CrossRefGoogle Scholar
  5. 5.
    Kahaleh M, Hernandez AJ, Tokar J, Adams RB, Shami VM, Yeaton P. EUS-guided pancreaticogastrostomy: analysis of its efficacy to drain inaccessible pancreatic ducts. Gastrointest Endosc. 2007;65(2):224–30.CrossRefGoogle Scholar
  6. 6.
    Kurihara T, Itoi T, Sofuni A, Itokawa F, Moriyasu F. Endoscopic ultrasonography-guided pancreatic duct drainage after failed endoscopic retrograde cholangiopancreatography in patients with malignant and benign pancreatic duct obstructions. Dig Endosc. 2013;25(Suppl 2):109–16.CrossRefGoogle Scholar
  7. 7.
    Takikawa T, Kanno A, Masamune A, Hamada S, Nakano E, Miura S, Ariga H, Unno J, Kume K, Kikuta K, Hirota M, Yoshida H, Katayose Y, Unno M, Shimosegawa T. Pancreatic duct drainage using EUS-guided rendezvous technique for stenotic pancreaticojejunostomy. World J Gastroenterol. 2013;19(31):5182–6.CrossRefGoogle Scholar
  8. 8.
    Ergun M, Aouattah T, Gillain C, Gigot JF, Hubert C, Deprez PH. Endoscopic ultrasound-guided transluminal drainage of pancreatic duct obstruction: long-term outcome. Endoscopy. 2011;43:518–25.CrossRefGoogle Scholar
  9. 9.
    Will U, Reichel A, Fueldner F, Meyer F. Endoscopic ultrasonography-guided drainage for patients with symptomatic obstruction and enlargement of the pancreatic duct. World J Gastroenterol. 2015;21(46):13140–51.CrossRefGoogle Scholar
  10. 10.
    Fujii-Lau LL, Levy MJ. Endoscopic ultrasound-guided pancreatic duct drainage. J Hepatobiliary Pancreat Sci. 2015;22:51–7.CrossRefGoogle Scholar
  11. 11.
    Itoi T, Kasuya K, Sofuni A, et al. Endoscopic ultrasonography-guided pancreatic duct access: techniques and literature review of pancreatography, transmural drainage and rendezvous techniques. Dig Endosc. 2013;25:241–52.CrossRefGoogle Scholar
  12. 12.
    Oh D, Park DH, Cho MK, et al. Feasibility and safety of a fully covered self-expandable metal stent with antimigration properties for EUS-guided pancreatic duct drainage: early and midterm outcomes (with video). Gastrointest Endosc. 2016;83:366–73.CrossRefGoogle Scholar
  13. 13.
    Tyberg A, Sharaiha RZ, Kedia P, et al. EUS-guided pancreatic drainage for pancreatic strictures after failed ERCP: a multicenter international collaborative study. Gastrointest Endosc. 2017;85:164–9.CrossRefGoogle Scholar
  14. 14.
    Chen YI, Levy MJ, Moreels TG, et al. An international multicenter study comparing EUS-guided pancreatic duct drainage with enteroscopy-assisted endoscopic retrograde pancreatography after Whipple surgery. Gastrointest Endosc. 2017;85:170–7.CrossRefGoogle Scholar
  15. 15.
    Giovannini M. Endoscopic ultrasound-guided pancreatic duct drainage: ready for the prime time? Endosc Ultrasound. 2017;6(5):281–4.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Head of Gastroenterology and Endoscopy DepartmentPaoli-Calmettes InstituteMarseilleFrance

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