Post written by Kazuhiro Minami, MD, from the Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.

Recently, the interventional EUS procedure has been performed in many facilities; however, EUS-guided pancreatic drainage (EUS-PD) remains extremely technically challenging. Generally, the normal pancreatic duct is too narrow to cannulate, and trans-pancreatic puncture carries a high risk of adverse events. In our case, in order to deploy stent to a thin pancreatic duct, the puncture line was carefully expanded step-wisely after EUS-guided puncture. We used a newly designed plastic stent in the pancreatic duct. This stent has a good insertion and remains in place because of its unique shape and the anti-migration flanges. Indeed, the pancreatic fistula had resolved after the treatment.

There are many patients with pancreatic disease that require pancreatic duct stent placement. With a conventional plastic stent, it has been reported that complications such as stent dysfunction or dislocation frequently occur. Therefore, we believe that this unique device is essential for EUS-PD.

In this report, we suggested that EUS-PD with this newly developed tube stent appears to be an effective means of treating pancreatic fistula after pancreatectomy. We hope that endoscopists will use this stent and know its effectiveness for EUS-PD. Hereafter, further study of EUS-PD with this stent is needed to evaluate its efficacy and safety.

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