Pancreatic duct (PD) leak leading to pancreatic ascites is a serious complication of chronic pancreatitis. Endoscopic management with endoscopic retrograde cholangiopancreatography (ERCP) has been found to be successful; however, if selective cannulation of the PD is unsuccessful, an endoscopic ultrasound-guided rendezvous procedure can help in bridging PD leaks, provided the duct is dilated. We report a successful endoscopic ultrasound-guided rendezvous procedure in a patient with PD leak, pancreatic ascites, and a nondilated duct with failed ERCP who was a poor candidate for surgery. The pancreatic ascites resolved following the procedure.
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http://dx.doi.org/10.14309/crj.2018.105 | DOI Listing |
Dig Dis Sci
January 2025
Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing, 100050, P.R. China.
Int J Surg Pathol
January 2025
Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
. To determine the accuracy of grading pancreatic well-differentiated neuroendocrine tumors (PanNETs) on endoscopic ultrasound-guided fine needle biopsy (EUS-FNB). .
View Article and Find Full Text PDFCancers (Basel)
December 2024
Department of Gastroenterology & Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Pancreatic cancer is associated with high rates of morbidity and mortality. Endoscopic ultrasound (EUS)-guided biopsy has become the standard diagnostic modality per the guidelines. The use of EUS has been growing for providing various treatments in patients with pancreatic cancers: biliary and gallbladder drainage for those with malignant biliary obstruction, gastroenterostomy for malignant gastric outlet obstruction, celiac plexus/ganglia neurolysis for pain control, radiofrequency ablation, placement of fiducial markers, and injection of local chemotherapeutic agents.
View Article and Find Full Text PDFGastrointest Endosc
January 2025
Department of Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital, Tokyo, Japan; Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
Background And Aims: Endoscopic ultrasound-guided peripancreatic fluid drainage (EUS-PFD) with on-demand endoscopic necrosectomy, increasingly utilized to manage walled-off necrosis (WON), is associated with substantial morbidity and mortality. This multicenter study aimed to externally validate recently developed quadrant (an abdominal quadrant distribution), necrosis, and infection (QNI) criteria for risk stratification in this setting.
Methods: Of 423 patients with pancreatic fluid collections treated in a large multi-institutional cohort between 2010 and 2020, 212 with available preprocedural computed tomography images were included.
JCEM Case Rep
January 2025
Department of Endocrinology, Tan Tock Seng Hospital, Singapore 308433.
A 75-year-old female presented with fasting hypoglycemic episodes. A supervised fast ended at 72 hours fulfilling Whipple triad, with suppressed insulin and C-peptide levels, but discordantly suppressed serum β-hydroxybutyrate levels. After 21 months of recurring symptoms, a repeat fast ended at 48 hours with Whipple triad, suppressed serum β-hydroxybutyrate level, and borderline nonsuppressed C-peptide level, suggesting endogenous hyperinsulinism.
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