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Diagnostic and Therapeutic Endoscopy
Volume 2010, Article ID 517864, 5 pages
http://dx.doi.org/10.1155/2010/517864
Case Report

Endosonography-Guided Pancreatic Duct Drainage for Chronic Pancreatitis: A Case Report and Review

Department of Gastroenterology, Sendai City Medical Center, Sendai, Miyagi 983-0824, Japan

Received 10 February 2010; Accepted 11 March 2010

Academic Editor: C. Mel Wilcox

Copyright © 2010 Kei Ito et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 50-year-old man was admitted to our department, complaining of epigastric pain and high fever. CT revealed a pseudocyst at the pancreatic head with upstream dilatation of the pancreatic duct (PD) and fluid collection surrounding the pancreas. Endosonography-guided PD drainage (ESPD) was performed because of unsuccessful ERCP. With a curved linear array echoendoscope, a 7.2 F catheter was placed in the PD. Laboratory data showed improvement in a few days and revealed disappearance of the fluid collection. Ten days after ESPD, a 7 F stent was placed in the PD via the puncture tract across the papilla of Vater followed by transpapillary replacement with a 10 F stent. CT showed a reduction in diameter of the PD and disappearance of the pseudocyst. ESPD is a feasible and useful procedure in selected patients with chronic pancreatitis showing stenosis of the main PD when transpapillary approach is impossible.