EUS-guided rendezvous pancreaticogastrostomy in a patient with central pancreatectomy

摘要

A 53-year-old woman who had undergone a central pancreatectomy for an insulinoma 20 years previously presented with recurrent acute pancreatitis. The distal pancreas had been anastomosed to the posterior wall of the stomach. CT revealed a dilated pancreatic duct (5 mm) suggestive of a pancreaticogastrostomy (PG) stricture (A). Previous EGD failed to identify the opening to the anastomosis. The patient was scheduled for EUS-guided pancreaticogastrostomy rendezvous. EUS was performed with a curved linear echoendoscope (GF-UCT 2000; Olympus, Tokyo, Japan), and a short-segment dilation of the pancreatic duct was identified in the body of the pancreas.