Clinical Endoscopy

Case Report

Duodenal Stricture due to Necrotizing Pancreatitis following Endoscopic Ultrasound-Guided Ethanol Ablation of a Pancreatic Cyst: A Case Report: Jung Won Chun, Sang Hyub Lee, Jin Ho Choi, Woo Hyun Paik, Ji Kon Ryu, Yong-Tae Kim; Clin Endosc 2019;52(5):510-515. Published online July 4, 2019; DOI: https://doi.org/10.5946/ce.2018.191

The frequency of incidental detection of pancreatic cystic lesions (PCLs) is increasing because of the frequent use of cross-sectional imaging. The appropriate treatment for PCLs is challenging, and endoscopic ultrasound-guided ablation for PCLs has been reported in several studies. Although the feasibility and efficacy of this therapeutic modality have been shown, the safety issues associated with the procedure are still a concern. We present a case of a 61-year-old man who underwent ultrasound-guided ethanol ablation for PCL and needed repeated endoscopic balloon dilatation for severe duodenal stricture caused by necrotizing pancreatitis after the cyst ablation therapy.

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Original Article

Pancreatic Necrosectomy through Sinus Tract Endoscopy: Mahesh Kumar Goenka, Usha Goenka, Md.Yasin Mujoo, Indrajit Kumar Tiwary, Sanjay Mahawar, Vijay Kumar Rai; Clin Endosc 2018;51(3):279-284. Published online January 4, 2018; DOI: https://doi.org/10.5946/ce.2017.066

Abstract PDF PubReader ePub

Background
/Aims: Direct endoscopic pancreatic necrosectomy is increasingly being utilized to treat infected or symptomatic walled-off necrosis (WON) located close to the stomach or duodenum. Laterally-placed WON has traditionally been treated surgically. We evaluated a less utilized technique of sinus tract endoscopy (STE) for symptomatic laterally-placed WON.
Methods
Two hundred seventy-six patients with acute pancreatitis admitted in our hospital, 32 had symptomatic or infected WON requiring intervention. Of the 12 patients with laterally placed WON, 10 were treated by STE. STE was performed with a standard adult gastroscope passed through a percutaneous tract created by the placement of a 32-Fr drain.
Results
Ten patients (7 males; mean age, 43.8 years) underwent STE. Mean number of sessions was 2.3 (range, 1–4), with mean time of 70 minutes for each session (range, 15–70 minutes). While 9 patients had complete success, 1 patient had fever and chose to undergo surgery. Two patients developed pneumoperitoneum, which was treated conservatively. There was no mortality, cutaneous fistula, or recurrence during follow-up.
Conclusions
Laterally placed WON can be successfully managed by STE performed through a percutaneously placed drain. Details of the technique and end-points of STE require further evaluation.

Citations

Citations to this article as recorded by

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