Post written by Samuel Han, MD, from the Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA.
In this video case report, we describe the use of laser dissection to treat a refractory pancreaticojejunostomy anastomotic stricture. Using a holmium laser fiber (272 µm), we treated the stricture in 3 quadrants under water immersion, which improves visibility and helps absorb the energy of the laser.
We wanted to showcase this video because laser therapy may present another treatment option for patients with refractory strictures where standard dilation and stenting fail to significantly improve the stricture. We also hope that this technique can be assessed prospectively to examine its long-term efficacy and safety.
We believe that laser dissection offers another endoscopic tool for treating patients with pancreatic duct strictures. This may be used as an adjunct treatment to dilation and stenting and can be performed with or without pancreatoscopy depending on the location of the stricture.
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