Efficacy of Early Endoscopic Ultrasound-Guided Transluminal Drainage for Postoperative Pancreatic Fistula

Figure 1

Clinical images of a representative patient who underwent endoscopic ultrasound-guided transluminal drainage (EUS-TD) for postoperative pancreatic fistula (POPF). (a) Preoperative computed tomography (CT) scan reveals a tumor in the pancreatic tail, diagnosed as a pancreatic neuroendocrine tumor. The patient underwent distal pancreatectomy. (b) CT scan performed 14 days after surgery shows an infected POPF of 75 mm diameter. (c) EUS imaging performed on day 15 after surgery shows peripancreatic fluid collection, into which a 19G needle is inserted via a transgastric route. (d) and (e) Two double-pigtailed plastic stents were inserted and can be observed on endoscopic imaging (d) and under fluoroscopic (e) guidance. (f) CT scan performed 2 weeks after EUS-TD reveals resolution of the POPF.