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Drainage for fluid collections post pancreatic surgery and acute pancreatitis: similar but different?
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Yousuke Nakai, Saburo Matsubara, Tsuyoshi Mukai, Tsuyoshi Hamada, Takashi Sasaki, Hirotoshi Ishiwatari, Susumu Hijioka, Hideyuki Shiomi, Mamoru Takenaka, Takuji Iwashita, Atsuhiro Masuda, Tomotaka Saito, Hiroyuki Isayama, Ichiro Yasuda, for the WONDERFUL study group in Japan
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Clin Endosc 2024;57(6):735-746. Published online May 17, 2024
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DOI: https://doi.org/10.5946/ce.2023.254
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 Abstract
 PDF PubReader ePub
- Postoperative pancreatic fistulas (POPFs) are common adverse events that occur after pancreatic surgery. Endoscopic ultrasonography (EUS)-guided drainage (EUS-D) is a first-line treatment, similar to that for pancreatic fluid collection (PFCs) after acute pancreatitis. However, some POPFs do not develop fluid collections depending on the presence or location of the surgical drain, whereas others develop fluid collections, such as postoperative fluid collections (POPFCs). Although POPFCs are similar to PFCs, the strategy and modality for POPF management need to be modified according to the presence of fluid collections, surgical drains, and surgical type. As discussed for PFCs, the indications, timing, and selection of interventions or stents for EUS-D have not been fully elucidated for POPFs. In this review, we discuss the management of POPFs and POPFCs in comparison with PFCs due to acute pancreatitis and summarize the topics that should be addressed in future studies.
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Evaluation of the mechanical properties of current biliary self-expandable metallic stents: axial and radial force, and axial force zero border
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Wataru Yamagata, Toshio Fujisawa, Takashi Sasaki, Rei Ishibashi, Tomotaka Saito, Shuntaro Yoshida, Shizuka No, Kouta Inoue, Yousuke Nakai, Naoki Sasahira, Hiroyuki Isayama
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Clin Endosc 2023;56(5):633-649. Published online April 10, 2023
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DOI: https://doi.org/10.5946/ce.2022.201
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 Graphical Abstract
Abstract
PDFPubReaderePub
 - Background
/Aims: Mechanical properties (MPs) and axial and radial force (AF and RF) may influence the efficacy and complications of self-expandable metallic stent (SEMS) placement. We measured the MPs of various SEMSs and examined their influence on the SEMS clinical ability.
Methods
We evaluated the MPs of 29 types of 10-mm SEMSs. RF was measured using a conventional measurement device. AF was measured using the conventional and new methods, and the correlation between the methods was evaluated.
Results
A high correlation in AFs was observed, as measured by the new and conventional manual methods. AF and RF scatterplots divided the SEMSs into three subgroups according to structure: hook-and-cross-type (low AF and RF), cross-type (high AF and low RF), and laser-cut-type (intermediate AF and high RF). The hook-and-cross-type had the largest axial force zero border (>20°), followed by the laser-cut and cross types.
Conclusions
MPs were related to stent structure. Hook-and-cross-type SEMSs had a low AF and high axial force zero border and were considered safest because they caused minimal stress on the biliary wall. However, the increase in RF must be overcome.
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Citations
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Endoscopic Ultrasound-Guided Biliary Drainage for Unresectable Hilar Malignant Biliary Obstruction
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Yousuke Nakai, Hirofumi Kogure, Hiroyuki Isayama, Kazuhiko Koike
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Clin Endosc 2019;52(3):220-225. Published online November 29, 2018
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DOI: https://doi.org/10.5946/ce.2018.094
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Abstract
PDFPubReaderePub
- Endoscopic transpapillary biliary drainage is the current standard of care for unresectable hilar malignant biliary obstruction (MBO) and bilateral metal stent placement is shown to have longer patency. However, technical and clinical failure is possible and percutaneous transhepatic biliary drainage (PTBD) is sometimes necessary. Endoscopic ultrasound-guided biliary drainage (EUS-BD) is increasingly being reported as an alternative rescue procedure to PTBD. EUS-BD has a potential advantage of not traversing the biliary stricture and internal drainage can be completed in a single session. Some approaches to bilateral biliary drainage for hilar MBO under EUS-guidance include a bridging method, hepaticoduodenostomy, and a combination of EUS-BD and transpapillary biliary drainage. The aim of this review is to summarize data on EUS-BD for hilar MBO and to clarify its advantages over the conventional approaches such as endoscopic transpapillary biliary drainage and PTBD.
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Citations
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Endoscopic Ultrasound-Guided Biliary Drainage for Benign Biliary Diseases
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Yousuke Nakai, Hirofumi Kogure, Hiroyuki Isayama, Kazuhiko Koike
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Clin Endosc 2019;52(3):212-219. Published online March 14, 2019
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DOI: https://doi.org/10.5946/ce.2018.188
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Abstract
PDFPubReaderePub
- Although endoscopic retrograde cholangiopancreatography (ERCP) is the first-line treatment for benign biliary diseases, this procedure is technically difficult in some conditions such as a surgically altered anatomy and gastric outlet obstruction. After a failed ERCP, a surgical or a percutaneous approach is selected as a rescue procedure; however, various endoscopic ultrasound (EUS)-guided interventions are increasingly utilized in pancreatobiliary diseases, including EUS-guided rendezvous for failed biliary cannulation, EUS-guided antegrade treatment for stone management, and EUS-guided hepaticogastrostomy for anastomotic strictures in patients with a surgically altered anatomy. There are some technical hurdles in EUS-guided interventions for benign biliary diseases owing to the difficulty in puncturing a relatively small bile duct and in subsequent guidewire manipulation, as well as the lack of dedicated devices. A recent major advancement in this field is the introduction of a 2-step approach, in which EUS-guided drainage is placed in the first session and antegrade treatment is performed in subsequent sessions. This approach allows the use of various techniques such as mechanical lithotripsy and cholangioscopy without a risk of bile leak. In summary, EUS-guided interventions are among the treatment options for benign biliary diseases; however, standardization of the procedure and development of a treatment algorithm are needed.
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Citations
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Hassan Atalla, Hideyuki Shiomi, Takuya Ikegawa, Takashi Kobayashi, Arata Sakai, Atsuhiro Masuda, Yuzo Kodama
Endoscopy.2021; 53(02): E52. CrossRef - EUS-guided hepaticogastrostomy as a gateway to intermittent access for biliary leak management
Michiel Bronswijk, Giuseppe Vanella, Baki Topal, Schalk Van der Merwe
Endoscopy.2021; 53(11): E427. CrossRef - Endoscopic ultrasound‐guided rendezvous with a combination of 22‐gauge needle and 0.018‐inch guidewire for acute cholangitis with Cronkhite‐Canada syndrome
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Digestive Endoscopy.2021;[Epub] CrossRef - What You Need to Know Before Performing Endoscopic Ultrasound-guided Hepaticogastrostomy
Tanyaporn Chantarojanasiri, Thawee Ratanachu-Ek, Nonthalee Pausawasdi
Clinical Endoscopy.2021; 54(3): 301. CrossRef - EUS-guided hepaticoenterostomy with using a dedicated plastic stent for the benign pancreaticobiliary diseases: A single-center study of a large case series
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Endoscopic Ultrasound.2021; 10(4): 294. CrossRef - GRUPUGE PERSPECTIVE: Endoscopic Ultrasound-Guided Biliary Drainage
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GE - Portuguese Journal of Gastroenterology.2021; 28(3): 179. CrossRef - Endoscopic management of difficult common bile duct stones: Where are we now? A comprehensive review
Alberto Tringali, Deborah Costa, Alessandro Fugazza, Matteo Colombo, Kareem Khalaf, Alessandro Repici, Andrea Anderloni
World Journal of Gastroenterology.2021; 27(44): 7597. CrossRef - Initial clinical experience of a steerable access device for EUS-guided biliary drainage
Marvin Ryou, Petros C. Benias, Vivek Kumbhari
Gastrointestinal Endoscopy.2020; 91(1): 178. CrossRef - Management of Difficult Bile Duct Stones by Large Balloon, Cholangioscopy, Enteroscopy and Endosonography
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Gut and Liver.2020; 14(3): 297. CrossRef - Piercing technique via cholangioscopy for the reconstruction of complete anastomotic obstruction after choledochojejunostomy
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Digestive Endoscopy.2020;[Epub] CrossRef - EUS-guided rendezvous with a steerable access needle in choledocholithiasis
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BMJ Open Gastroenterology.2020; 7(1): e000428. CrossRef - Treatment of Long-Limb Biliary-Enteric Anastomotic Strictures: ERCP, PTBD, or EUS?
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Digestive Diseases and Sciences.2019; 64(9): 2379. CrossRef
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