Endoscopic ultrasound guided biliary and pancreatic duct interventions

Table 2 Summary of recently published reports of endoscopic ultrasound-guided pancreatic interventions including > 9 patients

Pancreatic	Procedures (n)	MPD access	Stent placement		Success	Procedure related complications		Notes
			RV	TM	Per procedure, n (%) [per patient, n (%)]	n (%)	Type
Kinney et al[81] 2009	9	7/9 (78%)	4	-	4/9 (45%)	3/9 (33%)	Pancreatitis (1) Retroperitoneal and intraperitoneal air (1) Fever (1)	Retrospective All patients post Whipple procedure with endoscopic rendezvous attempted via the afferent limb Causes of failures: inability to access the MPD (2) and inability to traverse the pancreaticojejunal anastomosis with the guidewire (3) All patients with successful decompression had good short term clinical relief
Barklay et al[73]2010	21	18/21 (86%)	10a	-	10/21 (48%)	3/21 (14%)	Infection (1) Pancreatitis (1) Shaving of guidewire (1)	Retrospective Among 14 dilated MPDs and 7 normal calibre MPDs, the 3 failed pancreatograms occurred in patients with a normal calibre MPD Unable to pass wire to papilla in 8/12 patients: suboptimal angle (3), tight stricture (5) aFour patients successfully underwent rendezvous procedure, six patients successfully underwent repeat ERCP after methylene blue injection into MPD to aid identification of ampulla
Ergun et al[76] 2011	24 (20 pts)	20/20b (100%)	5	15	20/24 (83%) [18/20 (90%)]	2/24 (8%) [2/20 (10%)]	Bleeding (1) Perigastric collection (1)	Retrospective The reason for 24 procedures among 20 patients is unclear bSuccessful pancreatography reported in “all 20 patients”
Vila et al[52] 2012	19	NS	NS	NS	11/19 (60%)	5/19 (26%)	NSc	Retrospective case series pooling biliary and pancreatic intervention: 19 hospitals, 23 endoscopists, 106 biliary and 19 pancreatic interventions cComplication type per procedure is not specified. Of the 29 complications among the biliary and pancreatic interventions 5 were managed endoscopically, 3 with percutaneous intervention and 2 were managed surgically
Shah et al[47] 2012	30 (25 pts)	25/25d (100%)	9/16	10/14	19/30 (63%)e [19/22 (86%)d]	4/30 (13%)e	Pneumoperitoneum (1) Pancreatitis (3)	Retrospective dAfter pancreatography 3 patients were not felt to warrant intervention e30 therapeutic procedures were attempted (in 22 patients) due to significant crossover during intervention: 6 of 7 failed RV had attempted EUS guided antegrade therapy (5/6 successful); 2 of 3 failed antegrade EUS underwent attempted ERCP (double-balloon guided, 2/2 successful)
Kurahira et al[74] 2013	17 (14 pts)	17/17 (100%)	11	3 (4)f	15/17 (88%)	1/17 (6%)	Pssudocyst and aneurysm due to PD puncture (1)	Retrospective Two cases did not proceed after pancreatogram; complications during guidewire passage? f One patient had a temporary naso-pancreatic drain with subsequent stent insertions
Fujii et al[71] 2013	46 (43 pts)	45/46g (98%)	14	18	32/46g (70%) [32/43 (74%)]	16/46g (30%)	Abdominal Pain (13) Pancreatitis (1) Peri-panreatic abscess (1) Retained guidewire fragment (1)	Retrospective gFor successful stent placement, three additional procedures were required in two patients

Superscripts refer to specific comments in the “Notes” column. ERCP: Endoscopic retrograde cholangio-pancreatography; EUS: Endoscopic ultrasound; MPD: Main pancreatic duct; Pts: Patients; RV: Rendezvous; TM: Transmural.